ReceivedClaimProcedureFact

Properties

Reporting table name
dbo.ReceivedClaimProcedureFact
Granularity
A procedure on a received claim
Profile tables
none
Links to
  1. BillingProcedureDim
  2. CoverageDim
  3. DateDim
  4. DiagnosisBridge
  5. DiagnosisDim
  6. DrgDim
  7. PatientDim
  8. PatientDimSourceData
  9. PlaceOfServiceDim
  10. ProcedureDim
  11. ProviderDim
  12. ProviderDimSourceData
  13. ReceivedClaimFact
  14. ReceivedClaimProcedureFact
  15. ReceivedClaimProcedureModifierBridge
  16. RevenueCodeDim
Links from
  1. AccumulationInstanceFact
  2. ApClaimActionFact
  3. ApClaimProcessingCodeAuditFact
  4. ManagedCareTransactionFact
  5. QdmAssessmentPerformedEventFact
  6. QdmDeviceAppliedEventFact
  7. QdmDiagnosisEventFact
  8. QdmDiagnosticStudyPerformedEventFact
  9. QdmImmunizationAdministeredEventFact
  10. QdmInterventionPerformedEventFact
  11. QdmLaboratoryTestPerformedEventFact
  12. QdmPhysicalExamPerformedEventFact
  13. QdmProcedurePerformedEventFact
  14. QdmSymptomEventFact
  15. QmEncounterClaimMappingFact
  16. ReceivedClaimAnalyticsDataMart
  17. ReceivedClaimProcedureAttributeValueDim
  18. ReceivedClaimProcedureBundleMappingFact
  19. ReceivedClaimReferralMappingFact
  20. ReceivedClaimResponsibilityClassFact
  21. UtilMgmtAuthReqSvcRcvClmProcMappingFact
  22. ValueBasedPaymentEventFact
Snapshot on data change
Disabled
  • Columns

    ReceivedClaimProcedureKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No

    ReceivedClaimKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReceivedClaimId
    MsspPartAClaimsDetail.CUR_CLM_UNIQ_ID
    ReceivedClaimIdType

    "MsspClaimUniqueId"

    CMS ACO Part A Procedure Files Load
    ReceivedClaimId
    MsspPartAProcedureCode.CUR_CLM_UNIQ_ID
    ReceivedClaimIdType

    "MsspClaimUniqueId"

    CMS ACO Part B DME File Load
    ReceivedClaimId
    MsspPartBDme.CUR_CLM_UNIQ_ID
    ReceivedClaimIdType

    "MsspClaimUniqueId"

    CMS ACO Part B Physicians File Load
    ReceivedClaimId
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID
    ReceivedClaimIdType

    "MsspClaimUniqueId"

    CMS CJR DME Claim Procedure Load
    ReceivedClaimId
    CmsCjrDmeDetail.CLM_DT_SGNTR_SK
    CmsCjrDmeDetail.CLM_NUM_SK
    CmsCjrDmeDetail.CLM_TYPE_CD
    CmsCjrDmeDetail.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    ReceivedClaimIdType

    CmsCjrUniqueClaimId

    CMS CJR Home Health Claim Procedure Load
    ReceivedClaimId
    CmsCjrHomeHealthDetail.CLM_DT_SGNTR_SK
    CmsCjrHomeHealthDetail.CLM_NUM_SK
    CmsCjrHomeHealthDetail.CLM_TYPE_CD
    CmsCjrHomeHealthDetail.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    ReceivedClaimIdType

    CmsCjrUniqueClaimId

    CMS CJR Inpatient Claim Procedure Load
    ReceivedClaimId
    CmsCjrInpatientDetail.CLM_DT_SGNTR_SK
    CmsCjrInpatientDetail.CLM_NUM_SK
    CmsCjrInpatientDetail.CLM_TYPE_CD
    CmsCjrInpatientDetail.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    ReceivedClaimIdType

    CmsCjrUniqueClaimId

    CMS CJR Outpatient Claim Procedure Load
    ReceivedClaimId
    CmsCjrOutpatientDetail.CLM_DT_SGNTR_SK
    CmsCjrOutpatientDetail.CLM_NUM_SK
    CmsCjrOutpatientDetail.CLM_TYPE_CD
    CmsCjrOutpatientDetail.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    ReceivedClaimIdType

    CmsCjrUniqueClaimId

    CMS CJR Part B Claim Procedure Load
    ReceivedClaimId
    CmsCjrPartBDetail.CLM_DT_SGNTR_SK
    CmsCjrPartBDetail.CLM_NUM_SK
    CmsCjrPartBDetail.CLM_TYPE_CD
    CmsCjrPartBDetail.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    ReceivedClaimIdType

    CmsCjrUniqueClaimId

    CMS CJR Skilled Nursing Claim Procedure Load
    ReceivedClaimId
    CmsCjrSkilledNursingDetail.CLM_DT_SGNTR_SK
    CmsCjrSkilledNursingDetail.CLM_NUM_SK
    CmsCjrSkilledNursingDetail.CLM_TYPE_CD
    CmsCjrSkilledNursingDetail.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    ReceivedClaimIdType

    CmsCjrUniqueClaimId

    CMS CJR Surgical Procedure Load
    ReceivedClaimId
    CmsCjrHospiceHeader.CLM_DT_SGNTR_SK
    CmsCjrHospiceHeader.CLM_NUM_SK
    CmsCjrHospiceHeader.CLM_TYPE_CD
    CmsCjrHospiceHeader.GEO_BENE_SK
    CmsCjrInpatientHeader.CLM_DT_SGNTR_SK
    CmsCjrInpatientHeader.CLM_NUM_SK
    CmsCjrInpatientHeader.CLM_TYPE_CD
    CmsCjrInpatientHeader.GEO_BENE_SK
    CmsCjrPartBHeader.CLM_DT_SGNTR_SK
    CmsCjrPartBHeader.CLM_NUM_SK
    CmsCjrPartBHeader.CLM_TYPE_CD
    CmsCjrPartBHeader.GEO_BENE_SK
    CmsCjrSkilledNursingHeader.CLM_DT_SGNTR_SK
    CmsCjrSkilledNursingHeader.CLM_NUM_SK
    CmsCjrSkilledNursingHeader.CLM_TYPE_CD
    CmsCjrSkilledNursingHeader.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    ReceivedClaimIdType

    CmsCjrUniqueClaimId

    Data Aggregation ICD Procedure Load
    ReceivedClaimId
    AP_CLAIM_ICD_PROC.CLAIM_ID

    AP_CLAIM_ICD_PROC.CLAIM_ID

    ReceivedClaimIdType

    "EpicExternallyPaidClaimDataAggId"

    Data Aggregation Service Line Load
    ReceivedClaimId
    AP_CLAIM_PROC.CLAIM_ID
    ReceivedClaimIdType

    "EpicExternallyPaidClaimDataAggId"

    Externally Adjudicated ICD Procedure Load
    ReceivedClaimId
    AP_CLAIM_ICD_PROC.CLAIM_ID

    AP_CLAIM_ICD_PROC.CLAIM_ID

    ReceivedClaimIdType

    "EpicExternalPaidClaimInformationId"

    Externally Adjudicated Service Line Load
    ReceivedClaimId
    AP_CLAIM_PROC.CLAIM_ID
    AP_CLAIM_PROC_IDS.CLAIM_ID
    ReceivedClaimIdType

    "EpicExternalPaidClaimInformationId"

    Payer System ICD Procedure Load
    ReceivedClaimId
    AP_CLAIM_ICD_PROC.CLAIM_ID

    AP_CLAIM_ICD_PROC.CLAIM_ID

    ReceivedClaimIdType

    "EpicExternalPaidPayerSystemClaimId"

    Payer System Service Line Load
    ReceivedClaimId
    AP_CLAIM_PROC.CLAIM_ID
    AP_CLAIM_PROC_IDS.CLAIM_ID
    ReceivedClaimIdType

    "EpicExternalPaidPayerSystemClaimId"

    Received Claim ICD Procedure Load
    ReceivedClaimId
    AP_CLAIM_ICD_PROC.CLAIM_ID

    AP_CLAIM_ICD_PROC.CLAIM_ID

    ReceivedClaimIdType

    EpicClaimInformationId

    Received Claim Procedure Load
    ReceivedClaimId
    AP_CLAIM_PROC.CLAIM_ID
    AP_CLAIM_PROC_IDS.CLAIM_ID
    ReceivedClaimIdType

    "EpicClaimInformationId"

    PayerClaimId

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(100)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PayerClaimId
    MsspPartAClaimsDetail.CUR_CLM_UNIQ_ID
    CMS ACO Part A Procedure Files Load
    PayerClaimId
    MsspPartAProcedureCode.CUR_CLM_UNIQ_ID
    CMS ACO Part B DME File Load
    PayerClaimId
    MsspPartBDme.CUR_CLM_UNIQ_ID
    CMS ACO Part B Physicians File Load
    PayerClaimId
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID
    CMS CJR DME Claim Procedure Load
    PayerClaimId
    CmsCjrDmeDetail.CLM_DT_SGNTR_SK
    CmsCjrDmeDetail.CLM_NUM_SK
    CmsCjrDmeDetail.CLM_TYPE_CD
    CmsCjrDmeDetail.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Home Health Claim Procedure Load
    PayerClaimId
    CmsCjrHomeHealthDetail.CLM_DT_SGNTR_SK
    CmsCjrHomeHealthDetail.CLM_NUM_SK
    CmsCjrHomeHealthDetail.CLM_TYPE_CD
    CmsCjrHomeHealthDetail.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Inpatient Claim Procedure Load
    PayerClaimId
    CmsCjrInpatientDetail.CLM_DT_SGNTR_SK
    CmsCjrInpatientDetail.CLM_NUM_SK
    CmsCjrInpatientDetail.CLM_TYPE_CD
    CmsCjrInpatientDetail.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Outpatient Claim Procedure Load
    PayerClaimId
    CmsCjrOutpatientDetail.CLM_DT_SGNTR_SK
    CmsCjrOutpatientDetail.CLM_NUM_SK
    CmsCjrOutpatientDetail.CLM_TYPE_CD
    CmsCjrOutpatientDetail.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Part B Claim Procedure Load
    PayerClaimId
    CmsCjrPartBDetail.CLM_DT_SGNTR_SK
    CmsCjrPartBDetail.CLM_NUM_SK
    CmsCjrPartBDetail.CLM_TYPE_CD
    CmsCjrPartBDetail.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Skilled Nursing Claim Procedure Load
    PayerClaimId
    CmsCjrSkilledNursingDetail.CLM_DT_SGNTR_SK
    CmsCjrSkilledNursingDetail.CLM_NUM_SK
    CmsCjrSkilledNursingDetail.CLM_TYPE_CD
    CmsCjrSkilledNursingDetail.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    CMS CJR Surgical Procedure Load
    PayerClaimId
    CmsCjrHospiceHeader.CLM_DT_SGNTR_SK
    CmsCjrHospiceHeader.CLM_NUM_SK
    CmsCjrHospiceHeader.CLM_TYPE_CD
    CmsCjrHospiceHeader.GEO_BENE_SK
    CmsCjrInpatientHeader.CLM_DT_SGNTR_SK
    CmsCjrInpatientHeader.CLM_NUM_SK
    CmsCjrInpatientHeader.CLM_TYPE_CD
    CmsCjrInpatientHeader.GEO_BENE_SK
    CmsCjrPartBHeader.CLM_DT_SGNTR_SK
    CmsCjrPartBHeader.CLM_NUM_SK
    CmsCjrPartBHeader.CLM_TYPE_CD
    CmsCjrPartBHeader.GEO_BENE_SK
    CmsCjrSkilledNursingHeader.CLM_DT_SGNTR_SK
    CmsCjrSkilledNursingHeader.CLM_NUM_SK
    CmsCjrSkilledNursingHeader.CLM_TYPE_CD
    CmsCjrSkilledNursingHeader.GEO_BENE_SK

    GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK

    Data Aggregation ICD Procedure Load
    PayerClaimId
    CLM_VALUES.ICN
    Data Aggregation Service Line Load
    PayerClaimId
    CLM_VALUES.ICN
    Externally Adjudicated ICD Procedure Load
    PayerClaimId
    CLM_VALUES.ICN

    CLM_VALUES.ICN

    Externally Adjudicated Service Line Load
    PayerClaimId
    CLM_VALUES.ICN

    CLM_VALUES.ICN

    Payer System ICD Procedure Load
    PayerClaimId
    CLM_VALUES.ICN
    Payer System Service Line Load
    PayerClaimId
    CLM_VALUES.ICN
    Received Claim ICD Procedure Load
    PayerClaimId
    AP_CLAIM.ACCT_NUM_WITH_VEN
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.WORKFLOW_C

    If AP_CLAIM.WORKFLOW_C IN ( 4, 5 ) then AP_CLAIM.ACCT_NUM_WITH_VEN Otherwise AP_CLAIM.CLAIM_ID

    Received Claim Procedure Load
    PayerClaimId
    AP_CLAIM.ACCT_NUM_WITH_VEN
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.WORKFLOW_C

    If AP_CLAIM.WORKFLOW_C IN ( 4, 5 ) then AP_CLAIM.ACCT_NUM_WITH_VEN Otherwise AP_CLAIM.CLAIM_ID

    OriginalClaimProcedureKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    CMS ACO Part A Procedure Files Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    CMS CJR Home Health Claim Procedure Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    CMS CJR Inpatient Claim Procedure Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    CMS CJR Outpatient Claim Procedure Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    CMS CJR Part B Claim Procedure Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    CMS CJR Skilled Nursing Claim Procedure Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    CMS CJR Surgical Procedure Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    Data Aggregation ICD Procedure Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    Data Aggregation Service Line Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    Externally Adjudicated ICD Procedure Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    Externally Adjudicated Service Line Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    Payer System ICD Procedure Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    Payer System Service Line Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    Received Claim ICD Procedure Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    Received Claim Procedure Load
    OriginalClaimProcedureId

    NULL

    OriginalClaimProcedureIdType

    "NotApplicable"

    AdjustmentToClaimProcedureKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    "NotApplicable"

    CMS ACO Part A Procedure Files Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    "NotApplicable"

    CMS CJR Home Health Claim Procedure Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    "NotApplicable"

    CMS CJR Inpatient Claim Procedure Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    "NotApplicable"

    CMS CJR Outpatient Claim Procedure Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    "NotApplicable"

    CMS CJR Part B Claim Procedure Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    "NotApplicable"

    CMS CJR Skilled Nursing Claim Procedure Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    "NotApplicable"

    CMS CJR Surgical Procedure Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    "NotApplicable"

    Data Aggregation ICD Procedure Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    NotApplicable

    Data Aggregation Service Line Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    "NotApplicable"

    Externally Adjudicated ICD Procedure Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    NotApplicable

    Externally Adjudicated Service Line Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    "NotApplicable"

    Payer System ICD Procedure Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    NotApplicable

    Payer System Service Line Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    "NotApplicable"

    Received Claim ICD Procedure Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    NotApplicable

    Received Claim Procedure Load
    AdjustmentToClaimProcedureId

    NULL

    AdjustmentToClaimProcedureIdType

    "NotApplicable"

    ReversalToClaimProcedureKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    "NotApplicable"

    CMS ACO Part A Procedure Files Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    "NotApplicable"

    CMS CJR Home Health Claim Procedure Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    "NotApplicable"

    CMS CJR Inpatient Claim Procedure Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    "NotApplicable"

    CMS CJR Outpatient Claim Procedure Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    "NotApplicable"

    CMS CJR Part B Claim Procedure Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    "NotApplicable"

    CMS CJR Skilled Nursing Claim Procedure Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    "NotApplicable"

    CMS CJR Surgical Procedure Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    "NotApplicable"

    Data Aggregation ICD Procedure Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    NotApplicable

    Data Aggregation Service Line Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    "NotApplicable"

    Externally Adjudicated ICD Procedure Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    NotApplicable

    Externally Adjudicated Service Line Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    "NotApplicable"

    Payer System ICD Procedure Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    NotApplicable

    Payer System Service Line Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    "NotApplicable"

    Received Claim ICD Procedure Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    NotApplicable

    Received Claim Procedure Load
    ReversalToClaimProcedureId

    NULL

    ReversalToClaimProcedureIdType

    "NotApplicable"

    AdjustedByClaimProcedureKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    "NotApplicable"

    CMS ACO Part A Procedure Files Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    "NotApplicable"

    CMS CJR Home Health Claim Procedure Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    "NotApplicable"

    CMS CJR Inpatient Claim Procedure Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    "NotApplicable"

    CMS CJR Outpatient Claim Procedure Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    "NotApplicable"

    CMS CJR Part B Claim Procedure Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    "NotApplicable"

    CMS CJR Skilled Nursing Claim Procedure Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    "NotApplicable"

    CMS CJR Surgical Procedure Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    "NotApplicable"

    Data Aggregation ICD Procedure Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    NotApplicable

    Data Aggregation Service Line Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    "NotApplicable"

    Externally Adjudicated ICD Procedure Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    NotApplicable

    Externally Adjudicated Service Line Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    "NotApplicable"

    Payer System ICD Procedure Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    NotApplicable

    Payer System Service Line Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    "NotApplicable"

    Received Claim ICD Procedure Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    NotApplicable

    Received Claim Procedure Load
    AdjustedByClaimProcedureId

    NULL

    AdjustedByClaimProcedureIdType

    "NotApplicable"

    ReversedByClaimProcedureKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    "NotApplicable"

    CMS ACO Part A Procedure Files Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    "NotApplicable"

    CMS CJR Home Health Claim Procedure Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    "NotApplicable"

    CMS CJR Inpatient Claim Procedure Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    "NotApplicable"

    CMS CJR Outpatient Claim Procedure Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    "NotApplicable"

    CMS CJR Part B Claim Procedure Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    "NotApplicable"

    CMS CJR Skilled Nursing Claim Procedure Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    "NotApplicable"

    CMS CJR Surgical Procedure Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    "NotApplicable"

    Data Aggregation ICD Procedure Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    NotApplicable

    Data Aggregation Service Line Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    "NotApplicable"

    Externally Adjudicated ICD Procedure Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    NotApplicable

    Externally Adjudicated Service Line Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    "NotApplicable"

    Payer System ICD Procedure Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    NotApplicable

    Payer System Service Line Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    "NotApplicable"

    Received Claim ICD Procedure Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    NotApplicable

    Received Claim Procedure Load
    ReversedByClaimProcedureId

    NULL

    ReversedByClaimProcedureIdType

    "NotApplicable"

    PatientKey

    : integer
    Links to PatientDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PatientId
    MsspPartAClaimsDetail.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    PerformedStartDate
    MsspPartAClaimsDetail.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part A Procedure Files Load
    PatientId
    MsspPartAProcedureCode.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    PerformedStartDate
    MsspPartAProcedureCode.CLM_PRCDR_PRFRM_DT

    If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT

    CMS ACO Part B DME File Load
    PatientId
    MsspPartBDme.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    PerformedStartDate
    MsspPartBDme.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part B Physicians File Load
    PatientId
    MsspPartBPhysicians.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    PerformedStartDate
    MsspPartBPhysicians.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Procedure Load
    PatientId
    CmsCjrDmeHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PerformedStartDate
    CmsCjrDmeDetail.EXPNSDT1
    CMS CJR Home Health Claim Procedure Load
    PatientId
    CmsCjrHomeHealthHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PerformedStartDate
    CmsCjrHomeHealthDetail.REV_DT
    CMS CJR Inpatient Claim Procedure Load
    PatientId
    CmsCjrInpatientHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PerformedStartDate
    CmsCjrInpatientDetail.REV_DT
    CMS CJR Outpatient Claim Procedure Load
    PatientId
    CmsCjrOutpatientHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PerformedStartDate
    CmsCjrOutpatientDetail.REV_DT
    CMS CJR Part B Claim Procedure Load
    PatientId
    CmsCjrPartBHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PerformedStartDate
    CmsCjrPartBDetail.EXPNSDT1
    CMS CJR Skilled Nursing Claim Procedure Load
    PatientId
    CmsCjrSkilledNursingHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PerformedStartDate
    CmsCjrSkilledNursingDetail.REV_DT
    CMS CJR Surgical Procedure Load
    PatientId
    CmsCjrHospiceHeader.BENE_SK
    CmsCjrInpatientHeader.BENE_SK
    CmsCjrPartBHeader.BENE_SK
    CmsCjrSkilledNursingHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PerformedStartDate
    CmsCjrDiagnosesProcedures.CLM_PRCDR_PRFRM_DT
    Data Aggregation ICD Procedure Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Data Aggregation Service Line Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Externally Adjudicated ICD Procedure Load
    PatientId
    AP_CLAIM.PAT_ID
    AP_CLAIM_3.EXTERNAL_DEMOG_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID
    AP_CLAIM_3.EXTERNAL_DEMOG_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Externally Adjudicated Service Line Load
    PatientId
    AP_CLAIM.PAT_ID
    AP_CLAIM_3.EXTERNAL_DEMOG_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID
    AP_CLAIM_3.EXTERNAL_DEMOG_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Payer System ICD Procedure Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Payer System Service Line Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Received Claim ICD Procedure Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Received Claim Procedure Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    PatientDurableKey

    : integer
    Links to PatientDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PatientId
    MsspPartAClaimsDetail.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    CMS ACO Part A Procedure Files Load
    PatientId
    MsspPartAProcedureCode.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    CMS ACO Part B DME File Load
    PatientId
    MsspPartBDme.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    CMS ACO Part B Physicians File Load
    PatientId
    MsspPartBPhysicians.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    CMS CJR DME Claim Procedure Load
    PatientId
    CmsCjrDmeHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    CMS CJR Home Health Claim Procedure Load
    PatientId
    CmsCjrHomeHealthHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    CMS CJR Inpatient Claim Procedure Load
    PatientId
    CmsCjrInpatientHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    CMS CJR Outpatient Claim Procedure Load
    PatientId
    CmsCjrOutpatientHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    CMS CJR Part B Claim Procedure Load
    PatientId
    CmsCjrPartBHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    CMS CJR Skilled Nursing Claim Procedure Load
    PatientId
    CmsCjrSkilledNursingHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    CMS CJR Surgical Procedure Load
    PatientId
    CmsCjrHospiceHeader.BENE_SK
    CmsCjrInpatientHeader.BENE_SK
    CmsCjrPartBHeader.BENE_SK
    CmsCjrSkilledNursingHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    Data Aggregation ICD Procedure Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    Data Aggregation Service Line Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    Externally Adjudicated ICD Procedure Load
    PatientId
    AP_CLAIM.PAT_ID
    AP_CLAIM_3.EXTERNAL_DEMOG_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID
    AP_CLAIM_3.EXTERNAL_DEMOG_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    Externally Adjudicated Service Line Load
    PatientId
    AP_CLAIM.PAT_ID
    AP_CLAIM_3.EXTERNAL_DEMOG_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID
    AP_CLAIM_3.EXTERNAL_DEMOG_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    Payer System ICD Procedure Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    Payer System Service Line Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    Received Claim ICD Procedure Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    Received Claim Procedure Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PatientId
    MsspPartAClaimsDetail.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    PatientSourceName

    NULL (use source of the package)

    CMS ACO Part A Procedure Files Load
    PatientId
    MsspPartAProcedureCode.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    PatientSourceName

    NULL (use source of the package)

    CMS ACO Part B DME File Load
    PatientId
    MsspPartBDme.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    PatientSourceName

    NULL (use source of the package)

    CMS ACO Part B Physicians File Load
    PatientId
    MsspPartBPhysicians.BENE_HIC_NUM

    The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI"

    PatientIdType

    The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI"

    PatientSourceName

    NULL (use source of the package)

    CMS CJR DME Claim Procedure Load
    PatientId
    CmsCjrDmeHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PatientSourceName

    NULL (use source of the package)

    CMS CJR Home Health Claim Procedure Load
    PatientId
    CmsCjrHomeHealthHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PatientSourceName

    NULL (use source of the package)

    CMS CJR Inpatient Claim Procedure Load
    PatientId
    CmsCjrInpatientHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PatientSourceName

    NULL (use source of the package)

    CMS CJR Outpatient Claim Procedure Load
    PatientId
    CmsCjrOutpatientHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PatientSourceName

    NULL (use source of the package)

    CMS CJR Part B Claim Procedure Load
    PatientId
    CmsCjrPartBHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PatientSourceName

    NULL (use source of the package)

    CMS CJR Skilled Nursing Claim Procedure Load
    PatientId
    CmsCjrSkilledNursingHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PatientSourceName

    NULL (use source of the package)

    CMS CJR Surgical Procedure Load
    PatientId
    CmsCjrHospiceHeader.BENE_SK
    CmsCjrInpatientHeader.BENE_SK
    CmsCjrPartBHeader.BENE_SK
    CmsCjrSkilledNursingHeader.BENE_SK
    PatientIdType

    IdrBeneficiaryKey

    PatientSourceName

    NULL (use source of the package)

    Data Aggregation ICD Procedure Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName

    NULL (use source of the package)

    Data Aggregation Service Line Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName

    NULL (use source of the package)

    Externally Adjudicated ICD Procedure Load
    PatientId
    AP_CLAIM.PAT_ID
    AP_CLAIM_3.EXTERNAL_DEMOG_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID
    AP_CLAIM_3.EXTERNAL_DEMOG_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName

    NULL (use source of the package)

    Externally Adjudicated Service Line Load
    PatientId
    AP_CLAIM.PAT_ID
    AP_CLAIM_3.EXTERNAL_DEMOG_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID
    AP_CLAIM_3.EXTERNAL_DEMOG_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName

    NULL (use source of the package)

    Payer System ICD Procedure Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName

    NULL (use source of the package)

    Payer System Service Line Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName

    NULL (use source of the package)

    Received Claim ICD Procedure Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName

    NULL (use source of the package)

    Received Claim Procedure Load
    PatientId
    AP_CLAIM.PAT_ID
    ID_BUNDLE_DEMOG_DB_MAIN.IDENT_BUNDLE_ID

    If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID

    PatientIdType
    AP_CLAIM.PAT_ID

    If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId"

    PatientSourceName

    NULL (use source of the package)

    PrimaryCoverageKey

    : integer
    Links to CoverageDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PrimaryCoverageId
    MsspPartAClaimsHeader.CLM_NCH_PRMRY_PYR_CD

    If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact Otherwise NULL

    PrimaryCoverageIdType
    MsspPartAClaimsHeader.CLM_NCH_PRMRY_PYR_CD

    If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable"

    CMS ACO Part A Procedure Files Load
    PrimaryCoverageId
    MsspPartAClaimsHeader.CLM_NCH_PRMRY_PYR_CD

    If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact Otherwise NULL

    PrimaryCoverageIdType
    MsspPartAClaimsHeader.CLM_NCH_PRMRY_PYR_CD

    If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable"

    CMS ACO Part B DME File Load
    PrimaryCoverageId
    MsspPartBDme.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact Otherwise NULL

    PrimaryCoverageIdType
    MsspPartBDme.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable"

    CMS ACO Part B Physicians File Load
    PrimaryCoverageId
    MsspPartBPhysicians.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact Otherwise NULL

    PrimaryCoverageIdType
    MsspPartBPhysicians.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable"

    CMS CJR DME Claim Procedure Load
    PrimaryCoverageId
    CmsCjrDmeHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then CmsPayorEpicId Otherwise NotApplicable

    PrimaryCoverageIdType
    CmsCjrDmeHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then EpicPayorId Otherwise NotApplicable

    CMS CJR Home Health Claim Procedure Load
    PrimaryCoverageId
    CmsCjrHomeHealthHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL

    PrimaryCoverageIdType
    CmsCjrHomeHealthHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable

    CMS CJR Inpatient Claim Procedure Load
    PrimaryCoverageId
    CmsCjrInpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL

    PrimaryCoverageIdType
    CmsCjrInpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable

    CMS CJR Outpatient Claim Procedure Load
    PrimaryCoverageId
    CmsCjrOutpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL

    PrimaryCoverageIdType
    CmsCjrOutpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable

    CMS CJR Part B Claim Procedure Load
    PrimaryCoverageId
    CmsCjrPartbHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then CmsPayorEpicId Otherwise NotApplicable

    PrimaryCoverageIdType
    CmsCjrPartbHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then EpicPayorId Otherwise NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    PrimaryCoverageId
    CmsCjrSkilledNursingHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL

    PrimaryCoverageIdType
    CmsCjrSkilledNursingHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable

    CMS CJR Surgical Procedure Load
    PrimaryCoverageId
    CmsCjrHospiceHeader.PRPAYCD
    CmsCjrInpatientHeader.PRPAYCD
    CmsCjrPartbHeader.PRPAYAMT
    CmsCjrSkilledNursingHeader.PRPAYCD

    If claim is inpatient, skilled nursing, or hospice:

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL

    Otherwise if claim is Part B:

    If PRPAYAMT is NULL or PRPAYAMT = 0 then CmsPayorEpicId Otherwise NotApplicable

    PrimaryCoverageIdType
    CmsCjrHospiceHeader.PRPAYCD
    CmsCjrInpatientHeader.PRPAYCD
    CmsCjrPartbHeader.PRPAYAMT
    CmsCjrSkilledNursingHeader.PRPAYCD

    If claim is inpatient, skilled nursing, or hospice:

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable

    Otherwise if claim is Part B:

    If PRPAYAMT is NULL or PRPAYAMT = 0 then EpicPayorId Otherwise NotApplicable

    Data Aggregation ICD Procedure Load
    PrimaryCoverageId
    AP_CLAIM_3.PRIM_PAYOR_ID
    PrimaryCoverageIdType
    AP_CLAIM_3.PRIM_PAYOR_ID

    If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable"

    Data Aggregation Service Line Load
    PrimaryCoverageId
    AP_CLAIM_3.PRIM_PAYOR_ID
    PrimaryCoverageIdType
    AP_CLAIM_3.PRIM_PAYOR_ID

    If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable"

    Externally Adjudicated ICD Procedure Load
    PrimaryCoverageId
    AP_CLAIM_3.PRIM_PAYOR_ID

    AP_CLAIM_3.PRIM_PAYOR_ID

    PrimaryCoverageIdType
    AP_CLAIM_3.PRIM_PAYOR_ID

    If AP_CLAIM_3.PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable"

    Externally Adjudicated Service Line Load
    PrimaryCoverageId
    AP_CLAIM_3.PRIM_PAYOR_ID

    AP_CLAIM_3.PRIM_PAYOR_ID

    PrimaryCoverageIdType
    AP_CLAIM_3.PRIM_PAYOR_ID

    If AP_CLAIM_3.PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable"

    Payer System ICD Procedure Load
    PrimaryCoverageId
    AP_CLAIM_3.PRIM_PAYOR_ID
    PrimaryCoverageIdType
    AP_CLAIM_3.PRIM_PAYOR_ID

    If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable"

    Payer System Service Line Load
    PrimaryCoverageId
    AP_CLAIM_3.PRIM_PAYOR_ID
    PrimaryCoverageIdType
    AP_CLAIM_3.PRIM_PAYOR_ID

    If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable"

    Received Claim ICD Procedure Load
    PrimaryCoverageId
    AP_CLAIM.COVERAGE_ID
    PrimaryCoverageIdType

    EpicCoverageId

    Received Claim Procedure Load
    PrimaryCoverageId
    AP_CLAIM.COVERAGE_ID
    PrimaryCoverageIdType

    "EpicCoverageId"

    SecondCoverageKey

    : integer
    Links to CoverageDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SecondCoverageId
    MsspPartAClaimsHeader.CLM_NCH_PRMRY_PYR_CD

    If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId component configuration for ReceivedClaimFact

    SecondCoverageIdType
    MsspPartAClaimsHeader.CLM_NCH_PRMRY_PYR_CD

    If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "NotApplicable" Otherwise "EpicPayorId"

    CMS ACO Part A Procedure Files Load
    SecondCoverageId
    MsspPartAClaimsHeader.CLM_NCH_PRMRY_PYR_CD

    If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId component configuration for ReceivedClaimFact

    SecondCoverageIdType
    MsspPartAClaimsHeader.CLM_NCH_PRMRY_PYR_CD

    If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "NotApplicable" Otherwise "EpicPayorId"

    CMS ACO Part B DME File Load
    SecondCoverageId
    MsspPartBDme.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId component configuration for ReceivedClaimFact

    SecondCoverageIdType
    MsspPartBDme.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "NotApplicable" Otherwise "EpicPayorId"

    CMS ACO Part B Physicians File Load
    SecondCoverageId
    MsspPartBPhysicians.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId component configuration for ReceivedClaimFact

    SecondCoverageIdType
    MsspPartBPhysicians.CLM_PRMRY_PYR_CD

    If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "NotApplicable" Otherwise "EpicPayorId"

    CMS CJR DME Claim Procedure Load
    SecondCoverageId
    CmsCjrDmeHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then NULL Otherwise CmsPayorEpicId

    SecondCoverageIdType
    CmsCjrDmeHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then NotApplicable Otherwise EpicPayorId

    CMS CJR Home Health Claim Procedure Load
    SecondCoverageId
    CmsCjrHomeHealthHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId

    SecondCoverageIdType
    CmsCjrHomeHealthHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId

    CMS CJR Inpatient Claim Procedure Load
    SecondCoverageId
    CmsCjrInpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId

    SecondCoverageIdType
    CmsCjrInpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId

    CMS CJR Outpatient Claim Procedure Load
    SecondCoverageId
    CmsCjrOutpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId

    SecondCoverageIdType
    CmsCjrOutpatientHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId

    CMS CJR Part B Claim Procedure Load
    SecondCoverageId
    CmsCjrPartbHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then NULL Otherwise CmsPayorEpicId

    SecondCoverageIdType
    CmsCjrPartbHeader.PRPAYAMT

    If PRPAYAMT is NULL or PRPAYAMT = 0 then NotApplicable Otherwise EpicPayorId

    CMS CJR Skilled Nursing Claim Procedure Load
    SecondCoverageId
    CmsCjrSkilledNursingHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId

    SecondCoverageIdType
    CmsCjrSkilledNursingHeader.PRPAYCD

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId

    CMS CJR Surgical Procedure Load
    SecondCoverageId
    CmsCjrHospiceHeader.PRPAYCD
    CmsCjrInpatientHeader.PRPAYCD
    CmsCjrPartBHeader.PRPAYAMT
    CmsCjrSkilledNursingHeader.PRPAYCD

    If claim is inpatient, skilled nursing, or hospice:

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId

    Otherwise if claim is Part B:

    If PRPAYAMT is NULL or PRPAYAMT = 0 then NULL Otherwise CmsPayorEpicId

    SecondCoverageIdType
    CmsCjrHospiceHeader.PRPAYCD
    CmsCjrInpatientHeader.PRPAYCD
    CmsCjrPartBHeader.PRPAYAMT
    CmsCjrSkilledNursingHeader.PRPAYCD

    If claim is inpatient, skilled nursing, or hospice:

    If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId

    Otherwise if claim is Part B:

    If PRPAYAMT is NULL or PRPAYAMT = 0 then NotApplicable Otherwise EpicPayorId

    Data Aggregation ICD Procedure Load
    SecondCoverageId

    NULL

    SecondCoverageIdType

    NotApplicable

    Data Aggregation Service Line Load
    SecondCoverageId

    NULL

    SecondCoverageIdType

    "NotApplicable"

    Externally Adjudicated ICD Procedure Load
    SecondCoverageId

    NULL

    SecondCoverageIdType

    NotApplicable

    Externally Adjudicated Service Line Load
    SecondCoverageId

    NULL

    SecondCoverageIdType

    "NotApplicable"

    Payer System ICD Procedure Load
    SecondCoverageId

    NULL

    SecondCoverageIdType

    NotApplicable

    Payer System Service Line Load
    SecondCoverageId

    NULL

    SecondCoverageIdType

    "NotApplicable"

    Received Claim ICD Procedure Load
    SecondCoverageId

    NULL

    SecondCoverageIdType

    NotApplicable

    Received Claim Procedure Load
    SecondCoverageId

    NULL

    SecondCoverageIdType

    "NotApplicable"

    ThirdCoverageKey

    : integer
    Links to CoverageDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    CMS ACO Part A Procedure Files Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    CMS CJR Inpatient Claim Procedure Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    CMS CJR Outpatient Claim Procedure Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    CMS CJR Part B Claim Procedure Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    CMS CJR Surgical Procedure Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    Data Aggregation ICD Procedure Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    Data Aggregation Service Line Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    Externally Adjudicated ICD Procedure Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    Externally Adjudicated Service Line Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    Payer System ICD Procedure Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    Payer System Service Line Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    Received Claim ICD Procedure Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    NotApplicable

    Received Claim Procedure Load
    ThirdCoverageId

    NULL

    ThirdCoverageIdType

    "NotApplicable"

    PlaceOfServiceKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PlaceOfServiceId
    MsspPartAClaimsHeader.FAC_PRVDR_NPI_NUM
    PlaceOfServiceIdType

    "FacilityNpi"

    CMS ACO Part A Procedure Files Load
    PlaceOfServiceId

    NULL

    PlaceOfServiceIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    PlaceOfServiceId

    NULL

    PlaceOfServiceIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    PlaceOfServiceId

    NULL

    PlaceOfServiceIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    PlaceOfServiceId

    NULL

    PlaceOfServiceIdType

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    PlaceOfServiceId
    CmsCjrHomeHealthHeader.ORGNPINM
    PlaceOfServiceIdType

    FacilityNpi

    CMS CJR Inpatient Claim Procedure Load
    PlaceOfServiceId
    CmsCjrInpatientHeader.CLM_PROVIDER
    PlaceOfServiceIdType

    FacilityCcn

    CMS CJR Outpatient Claim Procedure Load
    PlaceOfServiceId
    CmsCjrOutpatientHeader.CLM_PROVIDER
    PlaceOfServiceIdType

    FacilityCcn

    CMS CJR Part B Claim Procedure Load
    PlaceOfServiceId

    NULL

    PlaceOfServiceIdType

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    PlaceOfServiceId
    CmsCjrSkilledNursingHeader.CLM_PROVIDER
    PlaceOfServiceIdType

    FacilityCcn

    CMS CJR Surgical Procedure Load
    PlaceOfServiceId
    CmsCjrHospiceHeader.CLM_PROVIDER
    CmsCjrInpatientHeader.CLM_PROVIDER
    CmsCjrSkilledNursingHeader.CLM_PROVIDER

    If claim is inpatient, skilled nursing, or hospice then CLM_PROVIDER Otherwise NULL

    PlaceOfServiceIdType

    If claim is inpatient, skilled nursing, or hospice then FacilityCcn Otherwise NotApplicable

    Data Aggregation ICD Procedure Load
    PlaceOfServiceId
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI

    PlaceOfServiceIdType
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi"

    Data Aggregation Service Line Load
    PlaceOfServiceId
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI
    SVC_LN_INFO.LN_SVC_FAC_NPI

    If LOC_ID is not NULL then LOC_ID Otherwise if LN_SVC_FAC_NPI is not NULL and the number of services has not been modified in the system then LN_SVC_FAC_NPI Otherwise SVC_FAC_NPI

    PlaceOfServiceIdType
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI
    SVC_LN_INFO.LN_SVC_FAC_NPI

    If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi"

    Externally Adjudicated ICD Procedure Load
    PlaceOfServiceId
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI

    PlaceOfServiceIdType
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi"

    Externally Adjudicated Service Line Load
    PlaceOfServiceId
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI
    SVC_LN_INFO.LN_SVC_FAC_NPI

    If LOC_ID is not NULL then LOC_ID Otherwise if LN_SVC_FAC_NPI is not NULL then LN_SVC_FAC_NPI Otherwise SVC_FAC_NPI

    PlaceOfServiceIdType
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI
    SVC_LN_INFO.LN_SVC_FAC_NPI

    If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi"

    Payer System ICD Procedure Load
    PlaceOfServiceId
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI

    PlaceOfServiceIdType
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi"

    Payer System Service Line Load
    PlaceOfServiceId
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI
    SVC_LN_INFO.LN_SVC_FAC_NPI

    If LOC_ID is not NULL then LOC_ID Otherwise if LN_SVC_FAC_NPI is not NULL and the number of services has not been modified in the system then LN_SVC_FAC_NPI Otherwise SVC_FAC_NPI

    PlaceOfServiceIdType
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI
    SVC_LN_INFO.LN_SVC_FAC_NPI

    If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi"

    Received Claim ICD Procedure Load
    PlaceOfServiceId
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI

    PlaceOfServiceIdType
    AP_CLAIM.LOC_ID
    CLM_VALUES_3.SVC_FAC_NPI

    If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi"

    Received Claim Procedure Load
    PlaceOfServiceId
    AP_CLAIM.LOC_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_3.SVC_FAC_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_SVC_FAC_NPI

    If LOC_ID is not NULL then LOC_ID Otherwise if LN_SVC_FAC_NPI is not NULL and the number of services has not been modified in the system then LN_SVC_FAC_NPI Otherwise SVC_FAC_NPI

    PlaceOfServiceIdType
    AP_CLAIM.LOC_ID

    If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi"

    CcnPlaceOfServiceKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    CcnPlaceOfServiceId
    MsspPartAClaimsDetail.PRVDR_OSCAR_NUM
    CcnPlaceOfServiceIdType

    "FacilityCcn"

    CMS ACO Part A Procedure Files Load
    CcnPlaceOfServiceId
    MsspPartAProcedureCode.PRVDR_OSCAR_NUM
    CcnPlaceOfServiceIdType

    "FacilityCcn"

    CMS ACO Part B DME File Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    CcnPlaceOfServiceId
    CmsCjrHomeHealthHeader.CLM_PROVIDER
    CcnPlaceOfServiceIdType

    FacilityCcn

    CMS CJR Inpatient Claim Procedure Load
    CcnPlaceOfServiceId
    CmsCjrInpatientHeader.CLM_PROVIDER
    CcnPlaceOfServiceIdType

    FacilityCcn

    CMS CJR Outpatient Claim Procedure Load
    CcnPlaceOfServiceId
    CmsCjrOutpatientHeader.CLM_PROVIDER
    CcnPlaceOfServiceIdType

    FacilityCcn

    CMS CJR Part B Claim Procedure Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    CcnPlaceOfServiceId
    CmsCjrSkilledNursingHeader.CLM_PROVIDER
    CcnPlaceOfServiceIdType

    FacilityCcn

    CMS CJR Surgical Procedure Load
    CcnPlaceOfServiceId
    CmsCjrHospiceHeader.CLM_PROVIDER
    CmsCjrInpatientHeader.CLM_PROVIDER
    CmsCjrSkilledNursingHeader.CLM_PROVIDER

    If claim is inpatient, skilled nursing, or hospice then CLM_PROVIDER Otherwise NULL

    CcnPlaceOfServiceIdType

    If claim is inpatient, skilled nursing, or hospice then FacilityCcn Otherwise NotApplicable

    Data Aggregation ICD Procedure Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    Unspecified

    Data Aggregation Service Line Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    "Unspecified"

    Externally Adjudicated ICD Procedure Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    Unspecified

    Externally Adjudicated Service Line Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    "Unspecified"

    Payer System ICD Procedure Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    Unspecified

    Payer System Service Line Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    "Unspecified"

    Received Claim ICD Procedure Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    Unspecified

    Received Claim Procedure Load
    CcnPlaceOfServiceId

    NULL

    CcnPlaceOfServiceIdType

    "Unspecified"

    BillingProviderKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderId
    MsspPartAClaimsHeader.FAC_PRVDR_NPI_NUM
    BillingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    MsspPartAClaimsDetail.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part A Procedure Files Load
    BillingProviderId
    MsspPartAClaimsHeader.FAC_PRVDR_NPI_NUM
    BillingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    MsspPartAProcedureCode.CLM_PRCDR_PRFRM_DT

    If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT

    CMS ACO Part B DME File Load
    BillingProviderId
    MsspPartBDme.PAYTO_PRVDR_NPI_NUM
    BillingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    MsspPartBDme.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part B Physicians File Load
    BillingProviderId

    NULL

    BillingProviderIdType

    "NotApplicable"

    PerformedStartDate
    MsspPartBPhysicians.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Procedure Load
    BillingProviderId

    NULL

    BillingProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrDmeDetail.EXPNSDT1
    CMS CJR Home Health Claim Procedure Load
    BillingProviderId
    CmsCjrHomeHealthHeader.ORGNPINM
    BillingProviderIdType

    EpicProviderNpi

    PerformedStartDate
    CmsCjrHomeHealthDetail.REV_DT
    CMS CJR Inpatient Claim Procedure Load
    BillingProviderId
    CmsCjrInpatientHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    PerformedStartDate
    CmsCjrInpatientDetail.REV_DT
    CMS CJR Outpatient Claim Procedure Load
    BillingProviderId
    CmsCjrOutpatientHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    PerformedStartDate
    CmsCjrOutpatientDetail.REV_DT
    CMS CJR Part B Claim Procedure Load
    BillingProviderId

    NULL

    BillingProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrPartBDetail.EXPNSDT1
    CMS CJR Skilled Nursing Claim Procedure Load
    BillingProviderId
    CmsCjrSkilledNursingHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    PerformedStartDate
    CmsCjrSkilledNursingDetail.REV_DT
    CMS CJR Surgical Procedure Load
    BillingProviderId
    CmsCjrHospiceHeader.CLM_PROVIDER
    CmsCjrInpatientHeader.CLM_PROVIDER
    CmsCjrSkilledNursingHeader.CLM_PROVIDER

    If claim is inpatient, skilled nursing, or hospice then CLM_PROVIDER Otherwise NULL

    BillingProviderIdType

    If claim is inpatient, skilled nursing, or hospice then FacilityCcn Otherwise NotApplicable

    PerformedStartDate
    CmsCjrDiagnosesProcedures.CLM_PRCDR_PRFRM_DT
    Data Aggregation ICD Procedure Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Data Aggregation Service Line Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType
    CLM_VALUES.RECORD_ID

    "EpicProviderNpi"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Externally Adjudicated ICD Procedure Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Externally Adjudicated Service Line Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Payer System ICD Procedure Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Payer System Service Line Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Received Claim ICD Procedure Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Received Claim Procedure Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    BillingProviderDurableKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderId
    MsspPartAClaimsHeader.FAC_PRVDR_NPI_NUM
    BillingProviderIdType

    "EpicProviderNpi"

    CMS ACO Part A Procedure Files Load
    BillingProviderId
    MsspPartAClaimsHeader.FAC_PRVDR_NPI_NUM
    BillingProviderIdType

    "EpicProviderNpi"

    CMS ACO Part B DME File Load
    BillingProviderId
    MsspPartBDme.PAYTO_PRVDR_NPI_NUM
    BillingProviderIdType

    "EpicProviderNpi"

    CMS ACO Part B Physicians File Load
    BillingProviderId

    NULL

    BillingProviderIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    BillingProviderId

    NULL

    BillingProviderIdType

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    BillingProviderId
    CmsCjrHomeHealthHeader.ORGNPINM
    BillingProviderIdType

    EpicProviderNpi

    CMS CJR Inpatient Claim Procedure Load
    BillingProviderId
    CmsCjrInpatientHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    CMS CJR Outpatient Claim Procedure Load
    BillingProviderId
    CmsCjrOutpatientHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    CMS CJR Part B Claim Procedure Load
    BillingProviderId

    NULL

    BillingProviderIdType

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    BillingProviderId
    CmsCjrSkilledNursingHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    CMS CJR Surgical Procedure Load
    BillingProviderId
    CmsCjrHospiceHeader.CLM_PROVIDER
    CmsCjrInpatientHeader.CLM_PROVIDER
    CmsCjrSkilledNursingHeader.CLM_PROVIDER

    If claim is inpatient, skilled nursing, or hospice then CLM_PROVIDER Otherwise NULL

    BillingProviderIdType

    If claim is inpatient, skilled nursing, or hospice then FacilityCcn Otherwise NotApplicable

    Data Aggregation ICD Procedure Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    Data Aggregation Service Line Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType
    CLM_VALUES.RECORD_ID

    "EpicProviderNpi"

    Externally Adjudicated ICD Procedure Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    Externally Adjudicated Service Line Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    Payer System ICD Procedure Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    Payer System Service Line Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    Received Claim ICD Procedure Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    Received Claim Procedure Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    BillingProviderSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderId
    MsspPartAClaimsHeader.FAC_PRVDR_NPI_NUM
    BillingProviderIdType

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    CMS ACO Part A Procedure Files Load
    BillingProviderId
    MsspPartAClaimsHeader.FAC_PRVDR_NPI_NUM
    BillingProviderIdType

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    CMS ACO Part B DME File Load
    BillingProviderId
    MsspPartBDme.PAYTO_PRVDR_NPI_NUM
    BillingProviderIdType

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    CMS ACO Part B Physicians File Load
    BillingProviderId

    NULL

    BillingProviderIdType

    "NotApplicable"

    BillingProviderSourceName

    NULL

    CMS CJR DME Claim Procedure Load
    BillingProviderId

    NULL

    BillingProviderIdType

    NotApplicable

    BillingProviderSourceName

    NULL

    CMS CJR Home Health Claim Procedure Load
    BillingProviderId
    CmsCjrHomeHealthHeader.ORGNPINM
    BillingProviderIdType

    EpicProviderNpi

    BillingProviderSourceName

    "NPPES"

    CMS CJR Inpatient Claim Procedure Load
    BillingProviderId
    CmsCjrInpatientHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    BillingProviderSourceName

    "CMS"

    CMS CJR Outpatient Claim Procedure Load
    BillingProviderId
    CmsCjrOutpatientHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    BillingProviderSourceName

    "CMS"

    CMS CJR Part B Claim Procedure Load
    BillingProviderId

    NULL

    BillingProviderIdType

    NotApplicable

    BillingProviderSourceName

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    BillingProviderId
    CmsCjrSkilledNursingHeader.CLM_PROVIDER
    BillingProviderIdType

    FacilityCcn

    BillingProviderSourceName

    "CMS"

    CMS CJR Surgical Procedure Load
    BillingProviderId
    CmsCjrHospiceHeader.CLM_PROVIDER
    CmsCjrInpatientHeader.CLM_PROVIDER
    CmsCjrSkilledNursingHeader.CLM_PROVIDER

    If claim is inpatient, skilled nursing, or hospice then CLM_PROVIDER Otherwise NULL

    BillingProviderIdType

    If claim is inpatient, skilled nursing, or hospice then FacilityCcn Otherwise NotApplicable

    BillingProviderSourceName

    "CMS"

    Data Aggregation ICD Procedure Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    Data Aggregation Service Line Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType
    CLM_VALUES.RECORD_ID

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    Externally Adjudicated ICD Procedure Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    Externally Adjudicated Service Line Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    Payer System ICD Procedure Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    Payer System Service Line Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    Received Claim ICD Procedure Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    Received Claim Procedure Load
    BillingProviderId
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.RECORD_ID
    BillingProviderIdType

    "EpicProviderNpi"

    BillingProviderSourceName

    "NPPES"

    ReferringProviderKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PerformedStartDate
    MsspPartAClaimsDetail.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    CMS ACO Part A Procedure Files Load
    PerformedStartDate
    MsspPartAProcedureCode.CLM_PRCDR_PRFRM_DT

    If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT

    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    PerformedStartDate
    MsspPartBDme.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    PerformedStartDate
    MsspPartBPhysicians.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    PerformedStartDate
    CmsCjrDmeDetail.EXPNSDT1
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    PerformedStartDate
    CmsCjrHomeHealthDetail.REV_DT
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Inpatient Claim Procedure Load
    PerformedStartDate
    CmsCjrInpatientDetail.REV_DT
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Outpatient Claim Procedure Load
    PerformedStartDate
    CmsCjrOutpatientDetail.REV_DT
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Part B Claim Procedure Load
    PerformedStartDate
    CmsCjrPartBDetail.EXPNSDT1
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    PerformedStartDate
    CmsCjrSkilledNursingDetail.REV_DT
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Surgical Procedure Load
    PerformedStartDate
    CmsCjrDiagnosesProcedures.CLM_PRCDR_PRFRM_DT
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    Data Aggregation ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Data Aggregation Service Line Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Externally Adjudicated ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Externally Adjudicated Service Line Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL or REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Payer System ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Payer System Service Line Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Received Claim ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Received Claim Procedure Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    ReferringProviderDurableKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    CMS ACO Part A Procedure Files Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Inpatient Claim Procedure Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Outpatient Claim Procedure Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Part B Claim Procedure Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    CMS CJR Surgical Procedure Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    Data Aggregation ICD Procedure Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Data Aggregation Service Line Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Externally Adjudicated ICD Procedure Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Externally Adjudicated Service Line Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL or REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Payer System ICD Procedure Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Payer System Service Line Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Received Claim ICD Procedure Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Received Claim Procedure Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    ReferringProviderSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    ReferringProviderSourceName

    NULL

    CMS ACO Part A Procedure Files Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    ReferringProviderSourceName

    NULL

    CMS ACO Part B DME File Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    ReferringProviderSourceName

    NULL

    CMS ACO Part B Physicians File Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    "NotApplicable"

    ReferringProviderSourceName

    NULL

    CMS CJR DME Claim Procedure Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    ReferringProviderSourceName

    NULL

    CMS CJR Home Health Claim Procedure Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    ReferringProviderSourceName

    NULL

    CMS CJR Inpatient Claim Procedure Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    ReferringProviderSourceName

    NULL

    CMS CJR Outpatient Claim Procedure Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    ReferringProviderSourceName

    NULL

    CMS CJR Part B Claim Procedure Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    ReferringProviderSourceName

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    ReferringProviderSourceName

    NULL

    CMS CJR Surgical Procedure Load
    ReferringProviderId

    NULL

    ReferringProviderIdType

    NotApplicable

    ReferringProviderSourceName

    NULL

    Data Aggregation ICD Procedure Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    ReferringProviderSourceName
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Data Aggregation Service Line Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    ReferringProviderSourceName
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Externally Adjudicated ICD Procedure Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    ReferringProviderSourceName
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Externally Adjudicated Service Line Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL or REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    ReferringProviderSourceName
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If REF_PROV_NPI is not NULL or LN_REF_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Payer System ICD Procedure Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    ReferringProviderSourceName
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Payer System Service Line Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    ReferringProviderSourceName
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Received Claim ICD Procedure Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    ReferringProviderSourceName
    AP_CLAIM.REF_PROV_ID
    CLM_VALUES_2.REF_PROV_NPI

    If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Received Claim Procedure Load
    ReferringProviderId
    AP_CLAIM.REF_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID

    ReferringProviderIdType
    AP_CLAIM.REF_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    ReferringProviderSourceName
    AP_CLAIM.REF_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.REF_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    RenderingProviderKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PerformedStartDate
    MsspPartAClaimsDetail.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    CMS ACO Part A Procedure Files Load
    PerformedStartDate
    MsspPartAProcedureCode.CLM_PRCDR_PRFRM_DT

    If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT

    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    PerformedStartDate
    MsspPartBDme.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    PerformedStartDate
    MsspPartBPhysicians.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    RenderingProviderId
    MsspPartBPhysicians.RNDRG_PRVDR_NPI_NUM
    RenderingProviderIdType

    "EpicProviderNpi"

    CMS CJR DME Claim Procedure Load
    PerformedStartDate
    CmsCjrDmeDetail.EXPNSDT1
    RenderingProviderId
    CmsCjrDmeHeader.PRFNPI
    RenderingProviderIdType

    EpicProviderNpi

    CMS CJR Home Health Claim Procedure Load
    PerformedStartDate
    CmsCjrHomeHealthDetail.REV_DT
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    CMS CJR Inpatient Claim Procedure Load
    PerformedStartDate
    CmsCjrInpatientDetail.REV_DT
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    CMS CJR Outpatient Claim Procedure Load
    PerformedStartDate
    CmsCjrOutpatientDetail.REV_DT
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    CMS CJR Part B Claim Procedure Load
    PerformedStartDate
    CmsCjrPartBDetail.EXPNSDT1
    RenderingProviderId
    CmsCjrPartBHeader.PRFNPI
    RenderingProviderIdType

    EpicProviderNpi

    CMS CJR Skilled Nursing Claim Procedure Load
    PerformedStartDate
    CmsCjrSkilledNursingDetail.REV_DT
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    CMS CJR Surgical Procedure Load
    PerformedStartDate
    CmsCjrDiagnosesProcedures.CLM_PRCDR_PRFRM_DT
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    Data Aggregation ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Data Aggregation Service Line Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM.WORKFLOW_C
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Externally Adjudicated ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Externally Adjudicated Service Line Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Payer System ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Payer System Service Line Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM.WORKFLOW_C
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Received Claim ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Received Claim Procedure Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    RenderingProviderDurableKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    CMS ACO Part A Procedure Files Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    RenderingProviderId
    MsspPartBPhysicians.RNDRG_PRVDR_NPI_NUM
    RenderingProviderIdType

    "EpicProviderNpi"

    CMS CJR DME Claim Procedure Load
    RenderingProviderId
    CmsCjrDmeHeader.PRFNPI
    RenderingProviderIdType

    EpicProviderNpi

    CMS CJR Home Health Claim Procedure Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    CMS CJR Inpatient Claim Procedure Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    CMS CJR Outpatient Claim Procedure Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    CMS CJR Part B Claim Procedure Load
    RenderingProviderId
    CmsCjrPartBHeader.PRFNPI
    RenderingProviderIdType

    EpicProviderNpi

    CMS CJR Skilled Nursing Claim Procedure Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    CMS CJR Surgical Procedure Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    Data Aggregation ICD Procedure Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Data Aggregation Service Line Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM.WORKFLOW_C
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Externally Adjudicated ICD Procedure Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Externally Adjudicated Service Line Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Payer System ICD Procedure Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Payer System Service Line Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM.WORKFLOW_C
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Received Claim ICD Procedure Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    Received Claim Procedure Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    RenderingProviderSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    RenderingProviderSourceName

    NULL

    CMS ACO Part A Procedure Files Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    RenderingProviderSourceName

    NULL

    CMS ACO Part B DME File Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    "NotApplicable"

    RenderingProviderSourceName

    NULL

    CMS ACO Part B Physicians File Load
    RenderingProviderId
    MsspPartBPhysicians.RNDRG_PRVDR_NPI_NUM
    RenderingProviderIdType

    "EpicProviderNpi"

    RenderingProviderSourceName

    "NPPES"

    CMS CJR DME Claim Procedure Load
    RenderingProviderId
    CmsCjrDmeHeader.PRFNPI
    RenderingProviderIdType

    EpicProviderNpi

    RenderingProviderSourceName

    "NPPES"

    CMS CJR Home Health Claim Procedure Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    RenderingProviderSourceName

    NULL

    CMS CJR Inpatient Claim Procedure Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    RenderingProviderSourceName

    NULL

    CMS CJR Outpatient Claim Procedure Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    RenderingProviderSourceName

    NULL

    CMS CJR Part B Claim Procedure Load
    RenderingProviderId
    CmsCjrPartBHeader.PRFNPI
    RenderingProviderIdType

    EpicProviderNpi

    RenderingProviderSourceName

    "NPPES"

    CMS CJR Skilled Nursing Claim Procedure Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    RenderingProviderSourceName

    NULL

    CMS CJR Surgical Procedure Load
    RenderingProviderId

    NULL

    RenderingProviderIdType

    NotApplicable

    RenderingProviderSourceName

    NULL

    Data Aggregation ICD Procedure Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    RenderingProviderSourceName
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES"

    Data Aggregation Service Line Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM.WORKFLOW_C
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    RenderingProviderSourceName
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM.WORKFLOW_C
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES"

    Externally Adjudicated ICD Procedure Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    RenderingProviderSourceName
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES"

    Externally Adjudicated Service Line Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    RenderingProviderSourceName
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LN_REND_NPI

    If REND_PROV_NPI is not NULL then "NPPES" Otherwise if LN_REND_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES"

    Payer System ICD Procedure Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    RenderingProviderSourceName
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES"

    Payer System Service Line Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM.WORKFLOW_C
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    RenderingProviderSourceName
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM.WORKFLOW_C
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES"

    Received Claim ICD Procedure Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    RenderingProviderSourceName
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI

    If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES"

    Received Claim Procedure Load
    RenderingProviderId
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID

    RenderingProviderIdType
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi"

    RenderingProviderSourceName
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM.PROV_ID
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_3.ASST_SURG_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI

    If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES"

    AttendingProviderKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderId
    MsspPartAClaimsHeader.ATNDG_PRVDR_NPI_NUM
    AttendingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    MsspPartAClaimsDetail.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part A Procedure Files Load
    AttendingProviderId
    MsspPartAClaimsHeader.ATNDG_PRVDR_NPI_NUM
    AttendingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    MsspPartAProcedureCode.CLM_PRCDR_PRFRM_DT

    If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT

    CMS ACO Part B DME File Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    "NotApplicable"

    PerformedStartDate
    MsspPartBDme.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part B Physicians File Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    "NotApplicable"

    PerformedStartDate
    MsspPartBPhysicians.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Procedure Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrDmeDetail.EXPNSDT1
    CMS CJR Home Health Claim Procedure Load
    AttendingProviderId
    CmsCjrHomeHealthHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    PerformedStartDate
    CmsCjrHomeHealthDetail.REV_DT
    CMS CJR Inpatient Claim Procedure Load
    AttendingProviderId
    CmsCjrInpatientHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    PerformedStartDate
    CmsCjrInpatientDetail.REV_DT
    CMS CJR Outpatient Claim Procedure Load
    AttendingProviderId
    CmsCjrOutpatientHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    PerformedStartDate
    CmsCjrOutpatientDetail.REV_DT
    CMS CJR Part B Claim Procedure Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrPartBDetail.EXPNSDT1
    CMS CJR Skilled Nursing Claim Procedure Load
    AttendingProviderId
    CmsCjrSkilledNursingHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    PerformedStartDate
    CmsCjrSkilledNursingDetail.REV_DT
    CMS CJR Surgical Procedure Load
    AttendingProviderId
    CmsCjrInpatientHeader.AT_NPI
    CmsCjrSkilledNursingHeader.AT_NPI

    If claim is inpatient or skilled nursing then AT_NPI Otherwise NULL

    AttendingProviderIdType

    If claim is inpatient or skilled nursing then EpicProviderNpi Otherwise NotApplicable

    PerformedStartDate
    CmsCjrDiagnosesProcedures.CLM_PRCDR_PRFRM_DT
    Data Aggregation ICD Procedure Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Data Aggregation Service Line Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Externally Adjudicated ICD Procedure Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Externally Adjudicated Service Line Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Payer System ICD Procedure Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Payer System Service Line Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Received Claim ICD Procedure Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Received Claim Procedure Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    AttendingProviderDurableKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderId
    MsspPartAClaimsHeader.ATNDG_PRVDR_NPI_NUM
    AttendingProviderIdType

    "EpicProviderNpi"

    CMS ACO Part A Procedure Files Load
    AttendingProviderId
    MsspPartAClaimsHeader.ATNDG_PRVDR_NPI_NUM
    AttendingProviderIdType

    "EpicProviderNpi"

    CMS ACO Part B DME File Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    AttendingProviderId
    CmsCjrHomeHealthHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    CMS CJR Inpatient Claim Procedure Load
    AttendingProviderId
    CmsCjrInpatientHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    CMS CJR Outpatient Claim Procedure Load
    AttendingProviderId
    CmsCjrOutpatientHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    CMS CJR Part B Claim Procedure Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    AttendingProviderId
    CmsCjrSkilledNursingHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    CMS CJR Surgical Procedure Load
    AttendingProviderId
    CmsCjrInpatientHeader.AT_NPI
    CmsCjrSkilledNursingHeader.AT_NPI

    If claim is inpatient or skilled nursing then AT_NPI Otherwise NULL

    AttendingProviderIdType

    If claim is inpatient or skilled nursing then EpicProviderNpi Otherwise NotApplicable

    Data Aggregation ICD Procedure Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    Data Aggregation Service Line Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Externally Adjudicated ICD Procedure Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    Externally Adjudicated Service Line Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Payer System ICD Procedure Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    Payer System Service Line Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Received Claim ICD Procedure Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    Received Claim Procedure Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    AttendingProviderSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderId
    MsspPartAClaimsHeader.ATNDG_PRVDR_NPI_NUM
    AttendingProviderIdType

    "EpicProviderNpi"

    AttendingProviderSourceName

    "NPPES"

    CMS ACO Part A Procedure Files Load
    AttendingProviderId
    MsspPartAClaimsHeader.ATNDG_PRVDR_NPI_NUM
    AttendingProviderIdType

    "EpicProviderNpi"

    AttendingProviderSourceName

    "NPPES"

    CMS ACO Part B DME File Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    "NotApplicable"

    AttendingProviderSourceName

    NULL

    CMS ACO Part B Physicians File Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    "NotApplicable"

    AttendingProviderSourceName

    NULL

    CMS CJR DME Claim Procedure Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    NotApplicable

    AttendingProviderSourceName

    NULL

    CMS CJR Home Health Claim Procedure Load
    AttendingProviderId
    CmsCjrHomeHealthHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    AttendingProviderSourceName

    "NPPES"

    CMS CJR Inpatient Claim Procedure Load
    AttendingProviderId
    CmsCjrInpatientHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    AttendingProviderSourceName

    "NPPES"

    CMS CJR Outpatient Claim Procedure Load
    AttendingProviderId
    CmsCjrOutpatientHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    AttendingProviderSourceName

    "NPPES"

    CMS CJR Part B Claim Procedure Load
    AttendingProviderId

    NULL

    AttendingProviderIdType

    NotApplicable

    AttendingProviderSourceName

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    AttendingProviderId
    CmsCjrSkilledNursingHeader.AT_NPI
    AttendingProviderIdType

    EpicProviderNpi

    AttendingProviderSourceName

    "NPPES"

    CMS CJR Surgical Procedure Load
    AttendingProviderId
    CmsCjrInpatientHeader.AT_NPI
    CmsCjrSkilledNursingHeader.AT_NPI

    If claim is inpatient or skilled nursing then AT_NPI Otherwise NULL

    AttendingProviderIdType

    If claim is inpatient or skilled nursing then EpicProviderNpi Otherwise NotApplicable

    AttendingProviderSourceName

    "NPPES"

    Data Aggregation ICD Procedure Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    AttendingProviderSourceName
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Data Aggregation Service Line Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    AttendingProviderSourceName
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Externally Adjudicated ICD Procedure Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    AttendingProviderSourceName
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Externally Adjudicated Service Line Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    AttendingProviderSourceName
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Payer System ICD Procedure Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    AttendingProviderSourceName
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Payer System Service Line Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    AttendingProviderSourceName
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Received Claim ICD Procedure Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    AttendingProviderSourceName
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Received Claim Procedure Load
    AttendingProviderId
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID

    AttendingProviderIdType
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    AttendingProviderSourceName
    AP_CLAIM.ATTEND_PROV_ID
    CLM_VALUES_2.ATT_PROV_NPI

    If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    OperatingProviderKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderId
    MsspPartAClaimsHeader.OPRTG_PRVDR_NPI_NUM
    OperatingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    MsspPartAClaimsDetail.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part A Procedure Files Load
    OperatingProviderId
    MsspPartAClaimsHeader.OPRTG_PRVDR_NPI_NUM
    OperatingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    MsspPartAProcedureCode.CLM_PRCDR_PRFRM_DT

    If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT

    CMS ACO Part B DME File Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    "NotApplicable"

    PerformedStartDate
    MsspPartBDme.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part B Physicians File Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    "NotApplicable"

    PerformedStartDate
    MsspPartBPhysicians.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Procedure Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrDmeDetail.EXPNSDT1
    CMS CJR Home Health Claim Procedure Load
    OperatingProviderId
    CmsCjrHomeHealthHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    PerformedStartDate
    CmsCjrHomeHealthDetail.REV_DT
    CMS CJR Inpatient Claim Procedure Load
    OperatingProviderId
    CmsCjrInpatientHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    PerformedStartDate
    CmsCjrInpatientDetail.REV_DT
    CMS CJR Outpatient Claim Procedure Load
    OperatingProviderId
    CmsCjrOutpatientHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    PerformedStartDate
    CmsCjrOutpatientDetail.REV_DT
    CMS CJR Part B Claim Procedure Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrPartBDetail.EXPNSDT1
    CMS CJR Skilled Nursing Claim Procedure Load
    OperatingProviderId
    CmsCjrSkilledNursingHeader.OP_NPI

    NULL

    OperatingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    CmsCjrSkilledNursingDetail.REV_DT
    CMS CJR Surgical Procedure Load
    OperatingProviderId
    CmsCjrInpatientHeader.OP_NPI
    CmsCjrSkilledNursingHeader.OP_NPI

    If claim is inpatient or skilled nursing then AT_NPI Otherwise NULL

    OperatingProviderIdType

    If claim is inpatient or skilled nursing then EpicProviderNpi Otherwise NotApplicable

    PerformedStartDate
    CmsCjrDiagnosesProcedures.CLM_PRCDR_PRFRM_DT
    Data Aggregation ICD Procedure Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Data Aggregation Service Line Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Externally Adjudicated ICD Procedure Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Externally Adjudicated Service Line Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL or OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Payer System ICD Procedure Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Payer System Service Line Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Received Claim ICD Procedure Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Received Claim Procedure Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    OperatingProviderDurableKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderId
    MsspPartAClaimsHeader.OPRTG_PRVDR_NPI_NUM
    OperatingProviderIdType

    "EpicProviderNpi"

    CMS ACO Part A Procedure Files Load
    OperatingProviderId
    MsspPartAClaimsHeader.OPRTG_PRVDR_NPI_NUM
    OperatingProviderIdType

    "EpicProviderNpi"

    CMS ACO Part B DME File Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    OperatingProviderId
    CmsCjrHomeHealthHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    CMS CJR Inpatient Claim Procedure Load
    OperatingProviderId
    CmsCjrInpatientHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    CMS CJR Outpatient Claim Procedure Load
    OperatingProviderId
    CmsCjrOutpatientHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    CMS CJR Part B Claim Procedure Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OperatingProviderId
    CmsCjrSkilledNursingHeader.OP_NPI

    NULL

    OperatingProviderIdType

    "EpicProviderNpi"

    CMS CJR Surgical Procedure Load
    OperatingProviderId
    CmsCjrInpatientHeader.OP_NPI
    CmsCjrSkilledNursingHeader.OP_NPI

    If claim is inpatient or skilled nursing then AT_NPI Otherwise NULL

    OperatingProviderIdType

    If claim is inpatient or skilled nursing then EpicProviderNpi Otherwise NotApplicable

    Data Aggregation ICD Procedure Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    Data Aggregation Service Line Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Externally Adjudicated ICD Procedure Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    Externally Adjudicated Service Line Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL or OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Payer System ICD Procedure Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    Payer System Service Line Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Received Claim ICD Procedure Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    Received Claim Procedure Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OperatingProviderSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderId
    MsspPartAClaimsHeader.OPRTG_PRVDR_NPI_NUM
    OperatingProviderIdType

    "EpicProviderNpi"

    OperatingProviderSourceName

    "NPPES"

    CMS ACO Part A Procedure Files Load
    OperatingProviderId
    MsspPartAClaimsHeader.OPRTG_PRVDR_NPI_NUM
    OperatingProviderIdType

    "EpicProviderNpi"

    OperatingProviderSourceName

    "NPPES"

    CMS ACO Part B DME File Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    "NotApplicable"

    OperatingProviderSourceName

    NULL

    CMS ACO Part B Physicians File Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    "NotApplicable"

    OperatingProviderSourceName

    NULL

    CMS CJR DME Claim Procedure Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    NotApplicable

    OperatingProviderSourceName

    NULL

    CMS CJR Home Health Claim Procedure Load
    OperatingProviderId
    CmsCjrHomeHealthHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    OperatingProviderSourceName

    "NPPES"

    CMS CJR Inpatient Claim Procedure Load
    OperatingProviderId
    CmsCjrInpatientHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    OperatingProviderSourceName

    "NPPES"

    CMS CJR Outpatient Claim Procedure Load
    OperatingProviderId
    CmsCjrOutpatientHeader.OP_NPI
    OperatingProviderIdType

    EpicProviderNpi

    OperatingProviderSourceName

    "NPPES"

    CMS CJR Part B Claim Procedure Load
    OperatingProviderId

    NULL

    OperatingProviderIdType

    NotApplicable

    OperatingProviderSourceName

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    OperatingProviderId
    CmsCjrSkilledNursingHeader.OP_NPI

    NULL

    OperatingProviderIdType

    "EpicProviderNpi"

    OperatingProviderSourceName

    "NPPES"

    CMS CJR Surgical Procedure Load
    OperatingProviderId
    CmsCjrInpatientHeader.OP_NPI
    CmsCjrSkilledNursingHeader.OP_NPI

    If claim is inpatient or skilled nursing then AT_NPI Otherwise NULL

    OperatingProviderIdType

    If claim is inpatient or skilled nursing then EpicProviderNpi Otherwise NotApplicable

    OperatingProviderSourceName

    "NPPES"

    Data Aggregation ICD Procedure Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    OperatingProviderSourceName
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Data Aggregation Service Line Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OperatingProviderSourceName
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Externally Adjudicated ICD Procedure Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    OperatingProviderSourceName
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Externally Adjudicated Service Line Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL or OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OperatingProviderSourceName
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If OPER_PROV_NPI is not NULL or LN_OPR_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Payer System ICD Procedure Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    OperatingProviderSourceName
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Payer System Service Line Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OperatingProviderSourceName
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Received Claim ICD Procedure Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    OperatingProviderSourceName
    AP_CLAIM.OPERATING_PROV_ID
    CLM_VALUES_2.OPER_PROV_NPI

    If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Received Claim Procedure Load
    OperatingProviderId
    AP_CLAIM.OPERATING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID

    OperatingProviderIdType
    AP_CLAIM.OPERATING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OperatingProviderSourceName
    AP_CLAIM.OPERATING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.OPER_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_OPR_NPI

    If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    OtherProviderKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderId
    MsspPartAClaimsHeader.OTHR_PRVDR_NPI_NUM
    OtherProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    MsspPartAClaimsDetail.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part A Procedure Files Load
    OtherProviderId
    MsspPartAClaimsHeader.OTHR_PRVDR_NPI_NUM
    OtherProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    MsspPartAProcedureCode.CLM_PRCDR_PRFRM_DT

    If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT

    CMS ACO Part B DME File Load
    OtherProviderId

    NULL

    OtherProviderIdType

    "NotApplicable"

    PerformedStartDate
    MsspPartBDme.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part B Physicians File Load
    OtherProviderId

    NULL

    OtherProviderIdType

    "NotApplicable"

    PerformedStartDate
    MsspPartBPhysicians.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrDmeDetail.EXPNSDT1
    CMS CJR Home Health Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrHomeHealthDetail.REV_DT
    CMS CJR Inpatient Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrInpatientDetail.REV_DT
    CMS CJR Outpatient Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrOutpatientDetail.REV_DT
    CMS CJR Part B Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrPartBDetail.EXPNSDT1
    CMS CJR Skilled Nursing Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrSkilledNursingDetail.REV_DT
    CMS CJR Surgical Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrDiagnosesProcedures.CLM_PRCDR_PRFRM_DT
    Data Aggregation ICD Procedure Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Data Aggregation Service Line Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Externally Adjudicated ICD Procedure Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Externally Adjudicated Service Line Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL or OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Payer System ICD Procedure Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Payer System Service Line Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Received Claim ICD Procedure Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Received Claim Procedure Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    OtherProviderDurableKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderId
    MsspPartAClaimsHeader.OTHR_PRVDR_NPI_NUM
    OtherProviderIdType

    "EpicProviderNpi"

    CMS ACO Part A Procedure Files Load
    OtherProviderId
    MsspPartAClaimsHeader.OTHR_PRVDR_NPI_NUM
    OtherProviderIdType

    "EpicProviderNpi"

    CMS ACO Part B DME File Load
    OtherProviderId

    NULL

    OtherProviderIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    OtherProviderId

    NULL

    OtherProviderIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    CMS CJR Inpatient Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    CMS CJR Outpatient Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    CMS CJR Part B Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    CMS CJR Surgical Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    Data Aggregation ICD Procedure Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    Data Aggregation Service Line Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Externally Adjudicated ICD Procedure Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    Externally Adjudicated Service Line Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL or OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Payer System ICD Procedure Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    Payer System Service Line Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    Received Claim ICD Procedure Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    Received Claim Procedure Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OtherProviderSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderId
    MsspPartAClaimsHeader.OTHR_PRVDR_NPI_NUM
    OtherProviderIdType

    "EpicProviderNpi"

    OtherProviderSourceName

    "NPPES"

    CMS ACO Part A Procedure Files Load
    OtherProviderId
    MsspPartAClaimsHeader.OTHR_PRVDR_NPI_NUM
    OtherProviderIdType

    "EpicProviderNpi"

    OtherProviderSourceName

    "NPPES"

    CMS ACO Part B DME File Load
    OtherProviderId

    NULL

    OtherProviderIdType

    "NotApplicable"

    OtherProviderSourceName

    NULL

    CMS ACO Part B Physicians File Load
    OtherProviderId

    NULL

    OtherProviderIdType

    "NotApplicable"

    OtherProviderSourceName

    NULL

    CMS CJR DME Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    OtherProviderSourceName

    NULL

    CMS CJR Home Health Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    OtherProviderSourceName

    NULL

    CMS CJR Inpatient Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    OtherProviderSourceName

    NULL

    CMS CJR Outpatient Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    OtherProviderSourceName

    NULL

    CMS CJR Part B Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    OtherProviderSourceName

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    OtherProviderSourceName

    NULL

    CMS CJR Surgical Procedure Load
    OtherProviderId

    NULL

    OtherProviderIdType

    NotApplicable

    OtherProviderSourceName

    NULL

    Data Aggregation ICD Procedure Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    OtherProviderSourceName
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Data Aggregation Service Line Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OtherProviderSourceName
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Externally Adjudicated ICD Procedure Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    OtherProviderSourceName
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Externally Adjudicated Service Line Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL or OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OtherProviderSourceName
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If OTH_PROV_NPI is not NULL or LN_OTH_OPR_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Payer System ICD Procedure Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    OtherProviderSourceName
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Payer System Service Line Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OtherProviderSourceName
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Received Claim ICD Procedure Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId

    OtherProviderSourceName
    AP_CLAIM.OTHER_PROV_ID
    CLM_VALUES_2.OTH_PROV_NPI

    If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    Received Claim Procedure Load
    OtherProviderId
    AP_CLAIM.OTHER_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID

    OtherProviderIdType
    AP_CLAIM.OTHER_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId"

    OtherProviderSourceName
    AP_CLAIM.OTHER_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.OTH_PROV_NPI
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_OTH_OPR_NPI

    If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package)

    OrderingProviderKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    "NotApplicable"

    PerformedStartDate
    MsspPartAClaimsDetail.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part A Procedure Files Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    "NotApplicable"

    PerformedStartDate
    MsspPartAProcedureCode.CLM_PRCDR_PRFRM_DT

    If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT

    CMS ACO Part B DME File Load
    OrderingProviderId
    MsspPartBDme.ORDRG_PRVDR_NPI_NUM
    OrderingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    MsspPartBDme.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part B Physicians File Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    "NotApplicable"

    PerformedStartDate
    MsspPartBPhysicians.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrDmeDetail.EXPNSDT1
    CMS CJR Home Health Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrHomeHealthDetail.REV_DT
    CMS CJR Inpatient Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrInpatientDetail.REV_DT
    CMS CJR Outpatient Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrOutpatientDetail.REV_DT
    CMS CJR Part B Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrPartBDetail.EXPNSDT1
    CMS CJR Skilled Nursing Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrSkilledNursingDetail.REV_DT
    CMS CJR Surgical Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    PerformedStartDate
    CmsCjrDiagnosesProcedures.CLM_PRCDR_PRFRM_DT
    Data Aggregation ICD Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Data Aggregation Service Line Load
    OrderingProviderId
    SVC_LN_INFO.LN_ORD_NPI

    If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI

    OrderingProviderIdType
    SVC_LN_INFO.LN_ORD_NPI

    "EpicProviderNpi"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Externally Adjudicated ICD Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Externally Adjudicated Service Line Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    "Unspecified"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Payer System ICD Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Payer System Service Line Load
    OrderingProviderId
    SVC_LN_INFO.LN_ORD_NPI

    If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI

    OrderingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Received Claim ICD Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Received Claim Procedure Load
    OrderingProviderId
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_ORD_NPI

    If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI

    OrderingProviderIdType

    "EpicProviderNpi"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    OrderingProviderDurableKey

    : integer
    Links to ProviderDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    "NotApplicable"

    CMS ACO Part A Procedure Files Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    OrderingProviderId
    MsspPartBDme.ORDRG_PRVDR_NPI_NUM
    OrderingProviderIdType

    "EpicProviderNpi"

    CMS ACO Part B Physicians File Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    CMS CJR Inpatient Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    CMS CJR Outpatient Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    CMS CJR Part B Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    CMS CJR Surgical Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    Data Aggregation ICD Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    Data Aggregation Service Line Load
    OrderingProviderId
    SVC_LN_INFO.LN_ORD_NPI

    If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI

    OrderingProviderIdType
    SVC_LN_INFO.LN_ORD_NPI

    "EpicProviderNpi"

    Externally Adjudicated ICD Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    Externally Adjudicated Service Line Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    "Unspecified"

    Payer System ICD Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    Payer System Service Line Load
    OrderingProviderId
    SVC_LN_INFO.LN_ORD_NPI

    If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI

    OrderingProviderIdType

    "EpicProviderNpi"

    Received Claim ICD Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    Received Claim Procedure Load
    OrderingProviderId
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_ORD_NPI

    If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI

    OrderingProviderIdType

    "EpicProviderNpi"

    OrderingProviderSourceDataDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    "NotApplicable"

    OrderingProviderSourceName

    NULL

    CMS ACO Part A Procedure Files Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    "NotApplicable"

    OrderingProviderSourceName

    NULL

    CMS ACO Part B DME File Load
    OrderingProviderId
    MsspPartBDme.ORDRG_PRVDR_NPI_NUM
    OrderingProviderIdType

    "EpicProviderNpi"

    OrderingProviderSourceName

    "NPPES"

    CMS ACO Part B Physicians File Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    "NotApplicable"

    OrderingProviderSourceName

    NULL

    CMS CJR DME Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    OrderingProviderSourceName

    NULL

    CMS CJR Home Health Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    OrderingProviderSourceName

    NULL

    CMS CJR Inpatient Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    OrderingProviderSourceName

    NULL

    CMS CJR Outpatient Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    OrderingProviderSourceName

    NULL

    CMS CJR Part B Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    OrderingProviderSourceName

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    OrderingProviderSourceName

    NULL

    CMS CJR Surgical Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    OrderingProviderSourceName

    NULL

    Data Aggregation ICD Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    OrderingProviderSourceName

    NULL

    Data Aggregation Service Line Load
    OrderingProviderId
    SVC_LN_INFO.LN_ORD_NPI

    If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI

    OrderingProviderIdType
    SVC_LN_INFO.LN_ORD_NPI

    "EpicProviderNpi"

    OrderingProviderSourceName
    SVC_LN_INFO.LN_ORD_NPI

    If LN_ORD_NPI is not NULL and the number of services has not been modified in the system then "NPPES"

    Externally Adjudicated ICD Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    OrderingProviderSourceName

    NULL

    Externally Adjudicated Service Line Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    "Unspecified"

    OrderingProviderSourceName
    Payer System ICD Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    OrderingProviderSourceName

    NULL

    Payer System Service Line Load
    OrderingProviderId
    SVC_LN_INFO.LN_ORD_NPI

    If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI

    OrderingProviderIdType

    "EpicProviderNpi"

    OrderingProviderSourceName
    SVC_LN_INFO.LN_ORD_NPI

    If LN_ORD_NPI is not NULL and the number of services has not been modified in the system then "NPPES"

    Received Claim ICD Procedure Load
    OrderingProviderId

    NULL

    OrderingProviderIdType

    NotApplicable

    OrderingProviderSourceName

    NULL

    Received Claim Procedure Load
    OrderingProviderId
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_ORD_NPI

    If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI

    OrderingProviderIdType

    "EpicProviderNpi"

    OrderingProviderSourceName
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_ORD_NPI

    If LN_ORD_NPI is not NULL and the number of services has not been modified in the system then "NPPES"

    DrgKey

    : integer
    Links to DrgDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DrgId

    This column isn't configured for use in reports. See an administrator for more information.

    DrgIdType

    This column isn't configured for use in reports. See an administrator for more information.

    CMS ACO Part A Procedure Files Load
    DrgId

    This column isn't configured for use in reports. See an administrator for more information.

    DrgIdType

    This column isn't configured for use in reports. See an administrator for more information.

    CMS ACO Part B DME File Load
    DrgId

    NULL

    DrgIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    DrgId

    NULL

    DrgIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    DrgId

    NULL

    DrgIdType

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    DrgId

    NULL

    DrgIdType

    NotApplicable

    CMS CJR Inpatient Claim Procedure Load
    DrgId

    This column isn't configured for use in reports. See an administrator for more information.

    DrgIdType

    This column isn't configured for use in reports. See an administrator for more information.

    CMS CJR Outpatient Claim Procedure Load
    DrgId

    NULL

    DrgIdType

    NotApplicable

    CMS CJR Part B Claim Procedure Load
    DrgId

    NULL

    DrgIdType

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    DrgId

    This column isn't configured for use in reports. See an administrator for more information.

    DrgIdType

    This column isn't configured for use in reports. See an administrator for more information.

    CMS CJR Surgical Procedure Load
    DrgId

    NULL

    DrgIdType

    If the claim is inpatient or skilled nursing then Unspecified Otherwise If the claim is Part B or hospice then NotApplicable

    Data Aggregation ICD Procedure Load
    DrgId
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID

    DrgIdType
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId"

    Data Aggregation Service Line Load
    DrgId
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID

    DrgIdType
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId"

    Externally Adjudicated ICD Procedure Load
    DrgId
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID

    DrgIdType
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId"

    Externally Adjudicated Service Line Load
    DrgId
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID

    DrgIdType
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId"

    Payer System ICD Procedure Load
    DrgId
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID

    DrgIdType
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId"

    Payer System Service Line Load
    DrgId
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID

    DrgIdType
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId"

    Received Claim ICD Procedure Load
    DrgId
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID

    DrgIdType
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId"

    Received Claim Procedure Load
    DrgId
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID

    DrgIdType
    AP_CLAIM_3.DRG_ID_TYPE_ID

    If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId"

    RevenueCodeKey

    : integer
    Links to RevenueCodeDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RevenueCodeId
    MsspPartAClaimsDetail.CLM_LINE_PROD_REV_CTR_CD
    RevenueCodeIdType

    "EpicRevenueCode"

    CMS ACO Part A Procedure Files Load
    RevenueCodeId

    NULL

    RevenueCodeIdType

    NotApplicable

    CMS ACO Part B DME File Load
    RevenueCodeId

    NULL

    RevenueCodeIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    RevenueCodeId

    NULL

    RevenueCodeIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    RevenueCodeId

    NULL

    RevenueCodeIdType

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    RevenueCodeId
    CmsCjrHomeHealthDetail.REV_CTR
    RevenueCodeIdType

    EpicRevenueCode

    CMS CJR Inpatient Claim Procedure Load
    RevenueCodeId
    CmsCjrInpatientDetail.REV_CTR
    RevenueCodeIdType

    EpicRevenueCode

    CMS CJR Outpatient Claim Procedure Load
    RevenueCodeId
    CmsCjrOutpatientDetail.REV_CTR
    RevenueCodeIdType

    EpicRevenueCode

    CMS CJR Part B Claim Procedure Load
    RevenueCodeId

    NULL

    RevenueCodeIdType

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    RevenueCodeId
    CmsCjrSkilledNursingDetail.REV_CTR
    RevenueCodeIdType

    EpicRevenueCode

    CMS CJR Surgical Procedure Load
    RevenueCodeId

    NULL

    RevenueCodeIdType

    NotApplicable

    Data Aggregation ICD Procedure Load
    RevenueCodeId

    NULL

    RevenueCodeIdType

    NotApplicable

    Data Aggregation Service Line Load
    RevenueCodeId
    CL_UB_REV_CODE.REVENUE_CODE
    SVC_LN_INFO.LN_REV_CD

    If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise if the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI LN_REV_CD

    RevenueCodeIdType
    CL_UB_REV_CODE.REVENUE_CODE
    SVC_LN_INFO.LN_REV_CD

    "EpicRevenueCode"

    Externally Adjudicated ICD Procedure Load
    RevenueCodeId

    NULL

    RevenueCodeIdType

    NotApplicable

    Externally Adjudicated Service Line Load
    RevenueCodeId
    CL_UB_REV_CODE.REVENUE_CODE
    SVC_LN_INFO.LN_REV_CD

    If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise LN_REV_CD

    RevenueCodeIdType

    "EpicRevenueCode"

    Payer System ICD Procedure Load
    RevenueCodeId

    NULL

    RevenueCodeIdType

    NotApplicable

    Payer System Service Line Load
    RevenueCodeId
    CL_UB_REV_CODE.REVENUE_CODE
    SVC_LN_INFO.LN_REV_CD

    If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise if the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI LN_REV_CD

    RevenueCodeIdType

    "EpicRevenueCode"

    Received Claim ICD Procedure Load
    RevenueCodeId

    NULL

    RevenueCodeIdType

    NotApplicable

    Received Claim Procedure Load
    RevenueCodeId
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CL_UB_REV_CODE.REVENUE_CODE
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REV_CD

    If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise if the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI LN_REV_CD

    RevenueCodeIdType

    "EpicRevenueCode"

    PrimaryDiagnosisKey

    : integer
    Links to DiagnosisDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PrimaryDiagnosisId
    MsspPartAClaimsHeader.PRNCPL_DGNS_CD
    PrimaryDiagnosisIdType
    MsspPartAClaimsHeader.DGNS_PRCDR_ICD_IND
    MsspPartAClaimsHeader.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable"

    CMS ACO Part A Procedure Files Load
    PrimaryDiagnosisId
    MsspPartAClaimsHeader.PRNCPL_DGNS_CD
    PrimaryDiagnosisIdType
    MsspPartAClaimsHeader.DGNS_PRCDR_ICD_IND
    MsspPartAClaimsHeader.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable"

    CMS ACO Part B DME File Load
    PrimaryDiagnosisId

    NULL

    PrimaryDiagnosisIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    PrimaryDiagnosisId
    MsspPartBPhysicians.CLM_LINE_DGNS_CD
    PrimaryDiagnosisIdType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable"

    CMS CJR DME Claim Procedure Load
    PrimaryDiagnosisId
    CmsCjrDmeDetail.PDGNS_CD
    PrimaryDiagnosisIdType
    CmsCjrDmeHeader.CLM_THRU_DT
    CmsCjrDmeHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    CMS CJR Home Health Claim Procedure Load
    PrimaryDiagnosisId
    CmsCjrHomeHealthHeader.PDGNS_CD
    PrimaryDiagnosisIdType
    CmsCjrHomeHealthHeader.CLM_THRU_DT
    CmsCjrHomeHealthHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    CMS CJR Inpatient Claim Procedure Load
    PrimaryDiagnosisId
    CmsCjrInpatientHeader.PDGNS_CD
    PrimaryDiagnosisIdType
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified

    CMS CJR Outpatient Claim Procedure Load
    PrimaryDiagnosisId
    CmsCjrOutpatientHeader.PDGNS_CD
    PrimaryDiagnosisIdType
    CmsCjrOutpatientHeader.CLM_THRU_DT
    CmsCjrOutpatientHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    CMS CJR Part B Claim Procedure Load
    PrimaryDiagnosisId
    CmsCjrPartBDetail.PDGNS_CD
    PrimaryDiagnosisIdType
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    CMS CJR Skilled Nursing Claim Procedure Load
    PrimaryDiagnosisId
    CmsCjrSkilledNursingHeader.PDGNS_CD
    PrimaryDiagnosisIdType
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified

    CMS CJR Surgical Procedure Load
    PrimaryDiagnosisId
    CmsCjrHospiceHeader.PDGNS_CD
    CmsCjrInpatientHeader.PDGNS_CD
    CmsCjrPartBHeader.PDGNS_CD
    CmsCjrSkilledNursingHeader.PDGNS_CD
    PrimaryDiagnosisIdType
    CmsCjrHospiceHeader.CLM_THRU_DT
    CmsCjrHospiceHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If claim is inpatient or skilled nursing:

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified

    Otherwise if claim is Part B or hospice:

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    Externally Adjudicated ICD Procedure Load
    PrimaryDiagnosisId

    NULL

    PrimaryDiagnosisIdType

    NotApplicable

    Externally Adjudicated Service Line Load
    PrimaryDiagnosisId
    PrimaryDiagnosisIdType

    "Unspecified"

    Received Claim ICD Procedure Load
    PrimaryDiagnosisId
    AP_CLAIM_DX.LINE
    CLARITY_EDG.DX_ID

    DX_ID where LINE = 1

    PrimaryDiagnosisIdType

    EpicDiagnosisId

    Received Claim Procedure Load
    PrimaryDiagnosisId
    AP_CLAIM_DX.DX_ID
    AP_CLAIM_DX.LINE

    DX_ID where LINE = 1

    PrimaryDiagnosisIdType

    "EpicDiagnosisId"

    AdmittingDiagnosisKey

    : integer
    Links to DiagnosisDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdmittingDiagnosisId
    MsspPartAClaimsHeader.ADMTG_DGNS_CD
    AdmittingDiagnosisIdType
    MsspPartAClaimsHeader.DGNS_PRCDR_ICD_IND
    MsspPartAClaimsHeader.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable"

    CMS ACO Part A Procedure Files Load
    AdmittingDiagnosisId
    MsspPartAClaimsHeader.ADMTG_DGNS_CD
    AdmittingDiagnosisIdType
    MsspPartAClaimsHeader.DGNS_PRCDR_ICD_IND
    MsspPartAClaimsHeader.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable"

    CMS ACO Part B DME File Load
    AdmittingDiagnosisId

    NULL

    AdmittingDiagnosisIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    AdmittingDiagnosisId

    NULL

    AdmittingDiagnosisIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    AdmittingDiagnosisId

    NULL

    AdmittingDiagnosisIdType

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    AdmittingDiagnosisId

    NULL

    AdmittingDiagnosisIdType

    NotApplicable

    CMS CJR Inpatient Claim Procedure Load
    AdmittingDiagnosisId
    CmsCjrInpatientHeader.ADMTG_DGNS_CD
    AdmittingDiagnosisIdType
    CmsCJrInpatientHeader.CLM_THRU_DT
    CmsCJrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified

    CMS CJR Outpatient Claim Procedure Load
    AdmittingDiagnosisId

    NULL

    AdmittingDiagnosisIdType

    NotApplicable

    CMS CJR Part B Claim Procedure Load
    AdmittingDiagnosisId

    NULL

    AdmittingDiagnosisIdType

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    AdmittingDiagnosisId
    CmsCjrSkilledNursingHeader.ADMTG_DGNS_CD
    AdmittingDiagnosisIdType
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified

    CMS CJR Surgical Procedure Load
    AdmittingDiagnosisId
    CmsCjrInpatientHeader.AMTG_DGNS_CD
    CmsCjrSkilledNursingHeader.AMTG_DGNS_CD

    If claim is inpatient or skilled nursing then ADMTG_DGNS_CD Otherwise NULL

    AdmittingDiagnosisIdType
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If claim is inpatient or skilled nursing:

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified

    Otherwise if claim is Part B or hospice then NotApplicable

    Data Aggregation ICD Procedure Load
    AdmittingDiagnosisId
    AP_CLAIM.ADMISSION_DX_ID
    AdmittingDiagnosisIdType

    EpicDiagnosisId

    Data Aggregation Service Line Load
    AdmittingDiagnosisId
    AP_CLAIM.ADMISSION_DX_ID
    AdmittingDiagnosisIdType
    AP_CLAIM.ADMISSION_DX_ID

    "EpicDiagnosisId"

    Externally Adjudicated ICD Procedure Load
    AdmittingDiagnosisId
    AP_CLAIM.ADMISSION_DX_ID
    AdmittingDiagnosisIdType

    EpicDiagnosisId

    Externally Adjudicated Service Line Load
    AdmittingDiagnosisId
    AP_CLAIM.ADMISSION_DX_ID
    AdmittingDiagnosisIdType

    "EpicDiagnosisId"

    Payer System ICD Procedure Load
    AdmittingDiagnosisId
    AP_CLAIM.ADMISSION_DX_ID
    AdmittingDiagnosisIdType

    EpicDiagnosisId

    Payer System Service Line Load
    AdmittingDiagnosisId
    AP_CLAIM.ADMISSION_DX_ID
    AdmittingDiagnosisIdType

    "EpicDiagnosisId"

    Received Claim ICD Procedure Load
    AdmittingDiagnosisId
    AP_CLAIM.ADMISSION_DX_ID
    AdmittingDiagnosisIdType

    EpicDiagnosisId

    Received Claim Procedure Load
    AdmittingDiagnosisId
    AP_CLAIM.ADMISSION_DX_ID
    AdmittingDiagnosisIdType

    "EpicDiagnosisId"

    DiagnosisComboKey

    : integer
    Links to DiagnosisBridge

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    "NotApplicable"

    CMS ACO Part A Procedure Files Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    DiagnosisComboId
    MsspPartBPhysicians.CLM_LINE_NUM
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID

    CUR_CLM_UNIQ_ID + "|" + CLM_LINE_NUM

    DiagnosisComboIdType

    "MsspClaimUniqueId|Line"

    CMS CJR DME Claim Procedure Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    NotApplicable

    CMS CJR Inpatient Claim Procedure Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    NotApplicable

    CMS CJR Outpatient Claim Procedure Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    NotApplicable

    CMS CJR Part B Claim Procedure Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    NotApplicable

    CMS CJR Surgical Procedure Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    NotApplicable

    Data Aggregation ICD Procedure Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    NotApplicable

    Data Aggregation Service Line Load
    DiagnosisComboId
    AP_CLAIM_PROC.TX_ID
    DiagnosisComboIdType

    "EpicArTransactionId:ReceivedClaimProcedure"

    Externally Adjudicated ICD Procedure Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    NotApplicable

    Externally Adjudicated Service Line Load
    DiagnosisComboId
    AP_CLAIM_PROC.TX_ID
    DiagnosisComboIdType

    "EpicArTransactionId:ReceivedClaimProcedure"

    Payer System ICD Procedure Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    NotApplicable

    Payer System Service Line Load
    DiagnosisComboId
    AP_CLAIM_PROC.TX_ID
    DiagnosisComboIdType

    "EpicArTransactionId:ReceivedClaimProcedure"

    Received Claim ICD Procedure Load
    DiagnosisComboId

    NULL

    DiagnosisComboIdType

    NotApplicable

    Received Claim Procedure Load
    DiagnosisComboId
    AP_CLAIM_PROC.TX_ID
    DiagnosisComboIdType

    "EpicArTransactionId:ReceivedClaimProcedure"

    DiagnosisComboIdTypeId

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    smallint
    Allows null
    Yes

    DiagnosisNumericId

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(38,0)
    Allows null
    Yes

    DiagnosisComboId

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    Yes
    Delete value
    empty string
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DiagnosisComboId

    NULL

    CMS ACO Part A Procedure Files Load
    DiagnosisComboId

    NULL

    CMS ACO Part B DME File Load
    DiagnosisComboId

    NULL

    CMS ACO Part B Physicians File Load
    DiagnosisComboId
    MsspPartBPhysicians.CLM_LINE_NUM
    MsspPartBPhysicians.CUR_CLM_UNIQ_ID

    CUR_CLM_UNIQ_ID + "|" + CLM_LINE_NUM

    CMS CJR DME Claim Procedure Load
    DiagnosisComboId

    NULL

    CMS CJR Home Health Claim Procedure Load
    DiagnosisComboId

    NULL

    CMS CJR Inpatient Claim Procedure Load
    DiagnosisComboId

    NULL

    CMS CJR Outpatient Claim Procedure Load
    DiagnosisComboId

    NULL

    CMS CJR Part B Claim Procedure Load
    DiagnosisComboId

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    DiagnosisComboId

    NULL

    CMS CJR Surgical Procedure Load
    DiagnosisComboId

    NULL

    Data Aggregation ICD Procedure Load
    DiagnosisComboId

    NULL

    Data Aggregation Service Line Load
    DiagnosisComboId
    AP_CLAIM_PROC.TX_ID
    Externally Adjudicated ICD Procedure Load
    DiagnosisComboId

    NULL

    Externally Adjudicated Service Line Load
    DiagnosisComboId
    AP_CLAIM_PROC.TX_ID
    Payer System ICD Procedure Load
    DiagnosisComboId

    NULL

    Payer System Service Line Load
    DiagnosisComboId
    AP_CLAIM_PROC.TX_ID
    Received Claim ICD Procedure Load
    DiagnosisComboId

    NULL

    Received Claim Procedure Load
    DiagnosisComboId
    AP_CLAIM_PROC.TX_ID

    FirstDiagnosisKey

    : integer
    Links to DiagnosisDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FirstDiagnosisId
    MsspPartADiagnosisCode.FirstDiagnosisCode
    FirstDiagnosisIdType

    If MsspPartADiagnosisCode.FirstDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FirstDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unspecified"

    CMS ACO Part A Procedure Files Load
    FirstDiagnosisId
    MsspPartADiagnosisCode.FirstDiagnosisCode
    FirstDiagnosisIdType

    If MsspPartADiagnosisCode.FirstDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FirstDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unspecified"

    CMS ACO Part B DME File Load
    FirstDiagnosisId

    NULL

    FirstDiagnosisIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    FirstDiagnosisId
    MsspPartBPhysicians.CLM_DGNS_1_CD
    FirstDiagnosisIdType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type"

    CMS CJR DME Claim Procedure Load
    FirstDiagnosisId
    CmsCjrDmeDetail.DGNS_CD
    FirstDiagnosisIdType
    CmsCjrDmeHeader.CLM_THRU_DT
    CmsCjrDmeHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    CMS CJR Home Health Claim Procedure Load
    FirstDiagnosisId

    NULL

    FirstDiagnosisIdType

    NotApplicable

    CMS CJR Inpatient Claim Procedure Load
    FirstDiagnosisId

    NULL

    FirstDiagnosisIdType

    NotApplicable

    CMS CJR Outpatient Claim Procedure Load
    FirstDiagnosisId
    CmsCjrOutpatientDetail.PDGNS_CD
    FirstDiagnosisIdType
    CmsCjrOutpatientDetail.PDGNS_CD
    CmsCjrOutpatientHeader.CLM_THRU_DT
    CmsCjrOutpatientHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    CMS CJR Part B Claim Procedure Load
    FirstDiagnosisId
    CmsCjrPartBDetail.DGNS_CD
    FirstDiagnosisIdType
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    CMS CJR Skilled Nursing Claim Procedure Load
    FirstDiagnosisId

    NULL

    FirstDiagnosisIdType

    NotApplicable

    CMS CJR Surgical Procedure Load
    FirstDiagnosisId

    NULL

    FirstDiagnosisIdType

    NotApplicable

    Data Aggregation ICD Procedure Load
    FirstDiagnosisId

    NULL

    FirstDiagnosisIdType

    NotApplicable

    Data Aggregation Service Line Load
    FirstDiagnosisId
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.DX_RANK
    FirstDiagnosisIdType
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.DX_RANK

    "EpicDiagnosisId"

    Externally Adjudicated ICD Procedure Load
    FirstDiagnosisId

    NULL

    FirstDiagnosisIdType

    NotApplicable

    Externally Adjudicated Service Line Load
    FirstDiagnosisId
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE

    DX_ID where AP_PROC_ASSOC_DX.LINE = 1

    FirstDiagnosisIdType

    EpicDiagnosisId

    Payer System ICD Procedure Load
    FirstDiagnosisId

    NULL

    FirstDiagnosisIdType

    NotApplicable

    Payer System Service Line Load
    FirstDiagnosisId
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.DX_RANK
    FirstDiagnosisIdType
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.DX_RANK

    "EpicDiagnosisId"

    Received Claim ICD Procedure Load
    FirstDiagnosisId

    NULL

    FirstDiagnosisIdType

    NotApplicable

    Received Claim Procedure Load
    FirstDiagnosisId
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE

    DX_ID where AP_PROC_ASSOC_DX.LINE = 1

    FirstDiagnosisIdType

    EpicDiagnosisId

    BillingProcedureKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProcedureId
    MsspPartAClaimsDetail.CLM_LINE_HCPCS_CD
    BillingProcedureIdType
    MsspPartAClaimsDetail.CLM_LINE_PROD_REV_CTR_CD

    "EpicHippsCode" if CLM_LINE_PROD_REV_CTR_CD is 0022, 0023, or 0024; otherwise "EpicHcpcsCode"

    PerformedStartDate
    MsspPartAClaimsDetail.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part A Procedure Files Load
    BillingProcedureId

    NULL

    BillingProcedureIdType

    "NotApplicable"

    PerformedStartDate
    MsspPartAProcedureCode.CLM_PRCDR_PRFRM_DT

    If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT

    CMS ACO Part B DME File Load
    BillingProcedureId
    MsspPartBDme.CLM_LINE_HCPCS_CD
    BillingProcedureIdType

    "EpicHcpcsCode"

    PerformedStartDate
    MsspPartBDme.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part B Physicians File Load
    BillingProcedureId
    MsspPartBPhysicians.CLM_LINE_HCPCS_CD
    BillingProcedureIdType

    "EpicHcpcsCode"

    PerformedStartDate
    MsspPartBPhysicians.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Procedure Load
    BillingProcedureId
    CmsCjrDmeDetail.HCPCS_CD
    BillingProcedureIdType

    EpicHcpcsCode

    PerformedStartDate
    CmsCjrDmeDetail.EXPNSDT1
    CMS CJR Home Health Claim Procedure Load
    BillingProcedureId
    CmsCjrHomeHealthDetail.HCPCS_CD
    BillingProcedureIdType

    EpicHcpcsCode

    PerformedStartDate
    CmsCjrHomeHealthDetail.REV_DT
    CMS CJR Inpatient Claim Procedure Load
    BillingProcedureId
    CmsCjrInpatientDetail.HCPCS_CD
    BillingProcedureIdType

    EpicHcpcsCode

    PerformedStartDate
    CmsCjrInpatientDetail.REV_DT
    CMS CJR Outpatient Claim Procedure Load
    BillingProcedureId
    CmsCjrOutpatientDetail.HCPCS_CD
    BillingProcedureIdType

    EpicHcpcsCode

    PerformedStartDate
    CmsCjrOutpatientDetail.REV_DT
    CMS CJR Part B Claim Procedure Load
    BillingProcedureId
    CmsCjrPartBDetail.HCPCS_CD
    BillingProcedureIdType

    EpicHcpcsCode

    PerformedStartDate
    CmsCjrPartBDetail.EXPNSDT1
    CMS CJR Skilled Nursing Claim Procedure Load
    BillingProcedureId
    CmsCjrSkilledNursingDetail.HCPCS_CD
    BillingProcedureIdType

    EpicHcpcsCode

    PerformedStartDate
    CmsCjrSkilledNursingDetail.REV_DT
    CMS CJR Surgical Procedure Load
    BillingProcedureId
    CmsCjrDiagnosesProcedure.CODE_VALUE
    BillingProcedureIdType
    CmsCjrHospiceHeader.CLM_THRU_DT
    CmsCjrHospiceHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If claim is inpatient or skilled nursing:

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-PCS Otherwise Unspecified

    Otherwise if the claim is Part B or hospice:

    If no CODE_VALUE for this claim where CLM_PROD_TYPE_CD = S-Procedure exists then HcpcsCode Otherwise If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-PCS Otherwise Unspecified

    PerformedStartDate
    CmsCjrDiagnosesProcedures.CLM_PRCDR_PRFRM_DT
    Data Aggregation ICD Procedure Load
    BillingProcedureId

    NULL

    BillingProcedureIdType

    NotApplicable

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Data Aggregation Service Line Load
    BillingProcedureId
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD

    BillingProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Externally Adjudicated ICD Procedure Load
    BillingProcedureId

    NULL

    BillingProcedureIdType

    NotApplicable

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Externally Adjudicated Service Line Load
    BillingProcedureId
    AP_CLAIM_PROC.PROC_ID
    CLARITY_EAP_OT.CODE_TYPE_C
    CLARITY_EAP_OT.CPT_CODE
    CLARITY_EAP_OT.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then LN_PROC_CD

    BillingProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then "EpicHcpcsCode"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Payer System ICD Procedure Load
    BillingProcedureId

    NULL

    BillingProcedureIdType

    NotApplicable

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Payer System Service Line Load
    BillingProcedureId
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD

    BillingProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Received Claim ICD Procedure Load
    BillingProcedureId

    NULL

    BillingProcedureIdType

    NotApplicable

    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Received Claim Procedure Load
    BillingProcedureId
    AP_CLAIM_PROC.PROC_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD

    BillingProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode"

    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    BillingProcedureDurableKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProcedureId
    MsspPartAClaimsDetail.CLM_LINE_HCPCS_CD
    BillingProcedureIdType
    MsspPartAClaimsDetail.CLM_LINE_PROD_REV_CTR_CD

    "EpicHippsCode" if CLM_LINE_PROD_REV_CTR_CD is 0022, 0023, or 0024; otherwise "EpicHcpcsCode"

    CMS ACO Part A Procedure Files Load
    BillingProcedureId

    NULL

    BillingProcedureIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    BillingProcedureId
    MsspPartBDme.CLM_LINE_HCPCS_CD
    BillingProcedureIdType

    "EpicHcpcsCode"

    CMS ACO Part B Physicians File Load
    BillingProcedureId
    MsspPartBPhysicians.CLM_LINE_HCPCS_CD
    BillingProcedureIdType

    "EpicHcpcsCode"

    CMS CJR DME Claim Procedure Load
    BillingProcedureId
    CmsCjrDmeDetail.HCPCS_CD
    BillingProcedureIdType

    EpicHcpcsCode

    CMS CJR Home Health Claim Procedure Load
    BillingProcedureId
    CmsCjrHomeHealthDetail.HCPCS_CD
    BillingProcedureIdType

    EpicHcpcsCode

    CMS CJR Inpatient Claim Procedure Load
    BillingProcedureId
    CmsCjrInpatientDetail.HCPCS_CD
    BillingProcedureIdType

    EpicHcpcsCode

    CMS CJR Outpatient Claim Procedure Load
    BillingProcedureId
    CmsCjrOutpatientDetail.HCPCS_CD
    BillingProcedureIdType

    EpicHcpcsCode

    CMS CJR Part B Claim Procedure Load
    BillingProcedureId
    CmsCjrPartBDetail.HCPCS_CD
    BillingProcedureIdType

    EpicHcpcsCode

    CMS CJR Skilled Nursing Claim Procedure Load
    BillingProcedureId
    CmsCjrSkilledNursingDetail.HCPCS_CD
    BillingProcedureIdType

    EpicHcpcsCode

    CMS CJR Surgical Procedure Load
    BillingProcedureId
    CmsCjrDiagnosesProcedure.CODE_VALUE
    BillingProcedureIdType
    CmsCjrHospiceHeader.CLM_THRU_DT
    CmsCjrHospiceHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If claim is inpatient or skilled nursing:

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-PCS Otherwise Unspecified

    Otherwise if the claim is Part B or hospice:

    If no CODE_VALUE for this claim where CLM_PROD_TYPE_CD = S-Procedure exists then HcpcsCode Otherwise If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-PCS Otherwise Unspecified

    Data Aggregation ICD Procedure Load
    BillingProcedureId

    NULL

    BillingProcedureIdType

    NotApplicable

    Data Aggregation Service Line Load
    BillingProcedureId
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD

    BillingProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode"

    Externally Adjudicated ICD Procedure Load
    BillingProcedureId

    NULL

    BillingProcedureIdType

    NotApplicable

    Externally Adjudicated Service Line Load
    BillingProcedureId
    AP_CLAIM_PROC.PROC_ID
    CLARITY_EAP_OT.CODE_TYPE_C
    CLARITY_EAP_OT.CPT_CODE
    CLARITY_EAP_OT.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then LN_PROC_CD

    BillingProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then "EpicHcpcsCode"

    Payer System ICD Procedure Load
    BillingProcedureId

    NULL

    BillingProcedureIdType

    NotApplicable

    Payer System Service Line Load
    BillingProcedureId
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD

    BillingProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode"

    Received Claim ICD Procedure Load
    BillingProcedureId

    NULL

    BillingProcedureIdType

    NotApplicable

    Received Claim Procedure Load
    BillingProcedureId
    AP_CLAIM_PROC.PROC_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD

    BillingProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode"

    ProcedureKey

    : integer
    Links to ProcedureDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PerformedStartDate
    MsspPartAClaimsDetail.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    ProcedureId
    MsspPartAClaimsDetail.CLM_LINE_HCPCS_CD
    ProcedureIdType
    MsspPartAClaimsDetail.CLM_LINE_PROD_REV_CTR_CD

    "EpicHippsCode" if CLM_LINE_PROD_REV_CTR_CD is 0022, 0023, or 0024; otherwise "EpicHcpcsCode"

    CMS ACO Part A Procedure Files Load
    PerformedStartDate
    MsspPartAProcedureCode.CLM_PRCDR_PRFRM_DT

    If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT

    ProcedureId
    MsspPartAProcedureCode.CLM_PRCDR_CD
    ProcedureIdType
    MsspPartAProcedureCode.DGNS_PRCDR_ICD_IND
    MsspPartAProcedureCode.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-PCS" Otherwise "NotApplicable"

    CMS ACO Part B DME File Load
    PerformedStartDate
    MsspPartBDme.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    ProcedureId
    MsspPartBDme.CLM_LINE_HCPCS_CD
    ProcedureIdType

    "EpicHcpcsCode"

    CMS ACO Part B Physicians File Load
    PerformedStartDate
    MsspPartBPhysicians.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    ProcedureId
    MsspPartBPhysicians.CLM_LINE_HCPCS_CD
    ProcedureIdType

    "EpicHcpcsCode"

    CMS CJR DME Claim Procedure Load
    PerformedStartDate
    CmsCjrDmeDetail.EXPNSDT1
    ProcedureId
    CmsCjrDmeDetail.HCPCS_CD
    ProcedureIdType

    EpicHcpcsCode

    CMS CJR Home Health Claim Procedure Load
    PerformedStartDate
    CmsCjrHomeHealthDetail.REV_DT
    ProcedureId
    CmsCjrHomeHealthDetail.HCPCS_CD
    ProcedureIdType

    EpicHcpcsCode

    CMS CJR Inpatient Claim Procedure Load
    PerformedStartDate
    CmsCjrInpatientDetail.REV_DT
    ProcedureId
    CmsCjrInpatientDetail.HCPCS_CD
    ProcedureIdType

    EpicHcpcsCode

    CMS CJR Outpatient Claim Procedure Load
    PerformedStartDate
    CmsCjrOutpatientDetail.REV_DT
    ProcedureId
    CmsCjrOutpatientDetail.HCPCS_CD
    ProcedureIdType

    EpicHcpcsCode

    CMS CJR Part B Claim Procedure Load
    PerformedStartDate
    CmsCjrPartBDetail.EXPNSDT1
    ProcedureId
    CmsCjrPartBDetail.HCPCS_CD
    ProcedureIdType

    EpicHcpcsCode

    CMS CJR Skilled Nursing Claim Procedure Load
    PerformedStartDate
    CmsCjrSkilledNursingDetail.REV_DT
    ProcedureId
    CmsCjrSkilledNursingDetail.HCPCS_CD
    ProcedureIdType

    EpicHcpcsCode

    CMS CJR Surgical Procedure Load
    PerformedStartDate
    CmsCjrDiagnosesProcedures.CLM_PRCDR_PRFRM_DT
    ProcedureId
    CmsCjrDiagnosesProcedures.CODE_VALUE
    ProcedureIdType
    CmsCjrHospiceHeader.CLM_THRU_DT
    CmsCjrHospiceHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBheader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If claim is inpatient or skilled nursing:

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-PCS Otherwise Unspecified

    Otherwise if the claim is Part B or hospice:

    If no CODE_VALUE for this claim where CLM_PROD_TYPE_CD = S-Procedure exists then HcpcsCode Otherwise If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-PCS Otherwise Unspecified

    Data Aggregation ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    ProcedureId
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    ProcedureIdType

    EpicIcdCode

    Data Aggregation Service Line Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    ProcedureId
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD

    ProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode"

    Externally Adjudicated ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    ProcedureId
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    ProcedureIdType

    EpicIcdCode

    Externally Adjudicated Service Line Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    ProcedureId
    AP_CLAIM_PROC.PROC_ID
    CLARITY_EAP_OT.CODE_TYPE_C
    CLARITY_EAP_OT.CPT_CODE
    CLARITY_EAP_OT.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then LN_PROC_CD

    ProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then "EpicHcpcsCode"

    Payer System ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    ProcedureId
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    ProcedureIdType

    EpicIcdCode

    Payer System Service Line Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    ProcedureId
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD

    ProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode"

    Received Claim ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    ProcedureId
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    ProcedureIdType

    EpicIcdCode

    Received Claim Procedure Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    ProcedureId
    AP_CLAIM_PROC.PROC_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD

    ProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode"

    ProcedureDurableKey

    : integer
    Links to ProcedureDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ProcedureId
    MsspPartAClaimsDetail.CLM_LINE_HCPCS_CD
    ProcedureIdType
    MsspPartAClaimsDetail.CLM_LINE_PROD_REV_CTR_CD

    "EpicHippsCode" if CLM_LINE_PROD_REV_CTR_CD is 0022, 0023, or 0024; otherwise "EpicHcpcsCode"

    CMS ACO Part A Procedure Files Load
    ProcedureId
    MsspPartAProcedureCode.CLM_PRCDR_CD
    ProcedureIdType
    MsspPartAProcedureCode.DGNS_PRCDR_ICD_IND
    MsspPartAProcedureCode.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-PCS" Otherwise "NotApplicable"

    CMS ACO Part B DME File Load
    ProcedureId
    MsspPartBDme.CLM_LINE_HCPCS_CD
    ProcedureIdType

    "EpicHcpcsCode"

    CMS ACO Part B Physicians File Load
    ProcedureId
    MsspPartBPhysicians.CLM_LINE_HCPCS_CD
    ProcedureIdType

    "EpicHcpcsCode"

    CMS CJR DME Claim Procedure Load
    ProcedureId
    CmsCjrDmeDetail.HCPCS_CD
    ProcedureIdType

    EpicHcpcsCode

    CMS CJR Home Health Claim Procedure Load
    ProcedureId
    CmsCjrHomeHealthDetail.HCPCS_CD
    ProcedureIdType

    EpicHcpcsCode

    CMS CJR Inpatient Claim Procedure Load
    ProcedureId
    CmsCjrInpatientDetail.HCPCS_CD
    ProcedureIdType

    EpicHcpcsCode

    CMS CJR Outpatient Claim Procedure Load
    ProcedureId
    CmsCjrOutpatientDetail.HCPCS_CD
    ProcedureIdType

    EpicHcpcsCode

    CMS CJR Part B Claim Procedure Load
    ProcedureId
    CmsCjrPartBDetail.HCPCS_CD
    ProcedureIdType

    EpicHcpcsCode

    CMS CJR Skilled Nursing Claim Procedure Load
    ProcedureId
    CmsCjrSkilledNursingDetail.HCPCS_CD
    ProcedureIdType

    EpicHcpcsCode

    CMS CJR Surgical Procedure Load
    ProcedureId
    CmsCjrDiagnosesProcedures.CODE_VALUE
    ProcedureIdType
    CmsCjrHospiceHeader.CLM_THRU_DT
    CmsCjrHospiceHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBheader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If claim is inpatient or skilled nursing:

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-PCS Otherwise Unspecified

    Otherwise if the claim is Part B or hospice:

    If no CODE_VALUE for this claim where CLM_PROD_TYPE_CD = S-Procedure exists then HcpcsCode Otherwise If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-PCS Otherwise Unspecified

    Data Aggregation ICD Procedure Load
    ProcedureId
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    ProcedureIdType

    EpicIcdCode

    Data Aggregation Service Line Load
    ProcedureId
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD

    ProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode"

    Externally Adjudicated ICD Procedure Load
    ProcedureId
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    ProcedureIdType

    EpicIcdCode

    Externally Adjudicated Service Line Load
    ProcedureId
    AP_CLAIM_PROC.PROC_ID
    CLARITY_EAP_OT.CODE_TYPE_C
    CLARITY_EAP_OT.CPT_CODE
    CLARITY_EAP_OT.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then LN_PROC_CD

    ProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then "EpicHcpcsCode"

    Payer System ICD Procedure Load
    ProcedureId
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    ProcedureIdType

    EpicIcdCode

    Payer System Service Line Load
    ProcedureId
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD

    ProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode"

    Received Claim ICD Procedure Load
    ProcedureId
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    ProcedureIdType

    EpicIcdCode

    Received Claim Procedure Load
    ProcedureId
    AP_CLAIM_PROC.PROC_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD

    ProcedureIdType
    AP_CLAIM_PROC.PROC_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode"

    ModifierComboKey

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ModifierComboId

    NULL

    ModifierComboIdType

    "NotApplicable"

    CMS ACO Part A Procedure Files Load
    ModifierComboId

    NULL

    ModifierComboIdType

    "NotApplicable"

    CMS ACO Part B DME File Load
    ModifierComboId

    NULL

    ModifierComboIdType

    "NotApplicable"

    CMS ACO Part B Physicians File Load
    ModifierComboId

    NULL

    ModifierComboIdType

    "NotApplicable"

    CMS CJR DME Claim Procedure Load
    ModifierComboId

    NULL

    ModifierComboIdType

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    ModifierComboId

    NULL

    ModifierComboIdType

    NotApplicable

    CMS CJR Inpatient Claim Procedure Load
    ModifierComboId

    NULL

    ModifierComboIdType

    NotApplicable

    CMS CJR Outpatient Claim Procedure Load
    ModifierComboId

    NULL

    ModifierComboIdType

    NotApplicable

    CMS CJR Part B Claim Procedure Load
    ModifierComboId

    NULL

    ModifierComboIdType

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    ModifierComboId

    NULL

    ModifierComboIdType

    NotApplicable

    Data Aggregation ICD Procedure Load
    ModifierComboId

    NULL

    ModifierComboIdType

    NotApplicable

    Data Aggregation Service Line Load
    ModifierComboId
    AP_CLAIM_PROC_MODIFIERS.MODIFIER_ID
    AP_CLAIM_PROC_MODIFIERS.TX_ID
    ModifierComboIdType

    "EpicArTransactionId"

    Externally Adjudicated ICD Procedure Load
    ModifierComboId

    NULL

    ModifierComboIdType

    NotApplicable

    Externally Adjudicated Service Line Load
    ModifierComboId
    AP_CLAIM_PROC_MODIFIERS.MODIFIER_ID
    AP_CLAIM_PROC_MODIFIERS.TX_ID
    ModifierComboIdType

    "EpicArTransactionId"

    Payer System ICD Procedure Load
    ModifierComboId

    NULL

    ModifierComboIdType

    NotApplicable

    Payer System Service Line Load
    ModifierComboId
    AP_CLAIM_PROC_MODIFIERS.MODIFIER_ID
    AP_CLAIM_PROC_MODIFIERS.TX_ID
    ModifierComboIdType

    "EpicArTransactionId"

    Received Claim ICD Procedure Load
    ModifierComboId

    NULL

    ModifierComboIdType

    NotApplicable

    Received Claim Procedure Load
    ModifierComboId
    AP_CLAIM_PROC_MODIFIERS.MODIFIER_ID
    AP_CLAIM_PROC_MODIFIERS.TX_ID
    ModifierComboIdType

    "EpicArTransactionId"

    ModifierComboIdTypeId

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    smallint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ModifierComboIdTypeId
    CMS ACO Part A Procedure Files Load
    ModifierComboIdTypeId
    CMS ACO Part B DME File Load
    ModifierComboIdTypeId
    CMS ACO Part B Physicians File Load
    ModifierComboIdTypeId
    CMS CJR DME Claim Procedure Load
    ModifierComboIdTypeId
    CMS CJR Home Health Claim Procedure Load
    ModifierComboIdTypeId
    CMS CJR Inpatient Claim Procedure Load
    ModifierComboIdTypeId
    CMS CJR Outpatient Claim Procedure Load
    ModifierComboIdTypeId
    CMS CJR Part B Claim Procedure Load
    ModifierComboIdTypeId
    CMS CJR Surgical Procedure Load
    ModifierComboIdTypeId
    Data Aggregation ICD Procedure Load
    ModifierComboIdTypeId
    Data Aggregation Service Line Load
    ModifierComboIdTypeId
    Externally Adjudicated ICD Procedure Load
    ModifierComboIdTypeId
    Externally Adjudicated Service Line Load
    ModifierComboIdTypeId
    Payer System ICD Procedure Load
    ModifierComboIdTypeId
    Payer System Service Line Load
    ModifierComboIdTypeId
    Received Claim ICD Procedure Load
    ModifierComboIdTypeId
    Received Claim Procedure Load
    ModifierComboIdTypeId

    ModifierNumericId

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(38,0)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ModifierNumericId
    CMS ACO Part A Procedure Files Load
    ModifierNumericId
    CMS ACO Part B DME File Load
    ModifierNumericId
    CMS ACO Part B Physicians File Load
    ModifierNumericId
    CMS CJR DME Claim Procedure Load
    ModifierNumericId
    CMS CJR Home Health Claim Procedure Load
    ModifierNumericId
    CMS CJR Inpatient Claim Procedure Load
    ModifierNumericId
    CMS CJR Outpatient Claim Procedure Load
    ModifierNumericId
    CMS CJR Part B Claim Procedure Load
    ModifierNumericId
    CMS CJR Skilled Nursing Claim Procedure Load
    ModifierNumericId
    CMS CJR Surgical Procedure Load
    ModifierNumericId
    Data Aggregation ICD Procedure Load
    ModifierNumericId
    Data Aggregation Service Line Load
    ModifierNumericId
    Externally Adjudicated ICD Procedure Load
    ModifierNumericId
    Externally Adjudicated Service Line Load
    ModifierNumericId
    Payer System ICD Procedure Load
    ModifierNumericId
    Payer System Service Line Load
    ModifierNumericId
    Received Claim ICD Procedure Load
    ModifierNumericId
    Received Claim Procedure Load
    ModifierNumericId

    ModifierComboId

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    Yes
    Delete value
    empty string
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ModifierComboId

    NULL

    CMS ACO Part A Procedure Files Load
    ModifierComboId

    NULL

    CMS ACO Part B DME File Load
    ModifierComboId

    NULL

    CMS ACO Part B Physicians File Load
    ModifierComboId

    NULL

    CMS CJR DME Claim Procedure Load
    ModifierComboId

    NULL

    CMS CJR Home Health Claim Procedure Load
    ModifierComboId

    NULL

    CMS CJR Inpatient Claim Procedure Load
    ModifierComboId

    NULL

    CMS CJR Outpatient Claim Procedure Load
    ModifierComboId

    NULL

    CMS CJR Part B Claim Procedure Load
    ModifierComboId

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    ModifierComboId

    NULL

    Data Aggregation ICD Procedure Load
    ModifierComboId

    NULL

    Data Aggregation Service Line Load
    ModifierComboId
    AP_CLAIM_PROC_MODIFIERS.MODIFIER_ID
    AP_CLAIM_PROC_MODIFIERS.TX_ID
    Externally Adjudicated ICD Procedure Load
    ModifierComboId

    NULL

    Externally Adjudicated Service Line Load
    ModifierComboId
    AP_CLAIM_PROC_MODIFIERS.MODIFIER_ID
    AP_CLAIM_PROC_MODIFIERS.TX_ID
    Payer System ICD Procedure Load
    ModifierComboId

    NULL

    Payer System Service Line Load
    ModifierComboId
    AP_CLAIM_PROC_MODIFIERS.MODIFIER_ID
    AP_CLAIM_PROC_MODIFIERS.TX_ID
    Received Claim ICD Procedure Load
    ModifierComboId

    NULL

    Received Claim Procedure Load
    ModifierComboId
    AP_CLAIM_PROC_MODIFIERS.MODIFIER_ID
    AP_CLAIM_PROC_MODIFIERS.TX_ID

    PerformedStartDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PerformedStartDate
    MsspPartAClaimsDetail.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part A Procedure Files Load
    PerformedStartDate
    MsspPartAProcedureCode.CLM_PRCDR_PRFRM_DT

    If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT

    CMS ACO Part B DME File Load
    PerformedStartDate
    MsspPartBDme.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS ACO Part B Physicians File Load
    PerformedStartDate
    MsspPartBPhysicians.CLM_LINE_FROM_DT

    If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT

    CMS CJR DME Claim Procedure Load
    PerformedStartDate
    CmsCjrDmeDetail.EXPNSDT1
    CMS CJR Home Health Claim Procedure Load
    PerformedStartDate
    CmsCjrHomeHealthDetail.REV_DT
    CMS CJR Inpatient Claim Procedure Load
    PerformedStartDate
    CmsCjrInpatientDetail.REV_DT
    CMS CJR Outpatient Claim Procedure Load
    PerformedStartDate
    CmsCjrOutpatientDetail.REV_DT
    CMS CJR Part B Claim Procedure Load
    PerformedStartDate
    CmsCjrPartBDetail.EXPNSDT1
    CMS CJR Skilled Nursing Claim Procedure Load
    PerformedStartDate
    CmsCjrSkilledNursingDetail.REV_DT
    CMS CJR Surgical Procedure Load
    PerformedStartDate
    CmsCjrDiagnosesProcedures.CLM_PRCDR_PRFRM_DT
    Data Aggregation ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Data Aggregation Service Line Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Externally Adjudicated ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Externally Adjudicated Service Line Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Payer System ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Payer System Service Line Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    Received Claim ICD Procedure Load
    PerformedStartDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Received Claim Procedure Load
    PerformedStartDate
    AP_CLAIM_PROC.SVC_FROM_DATE

    Time Zone: Unspecified

    PerformedEndDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PerformedEndDate
    MsspPartAClaimsDetail.CLM_LINE_THRU_DT

    If CLM_LINE_THRU_DT < 1/1/1753 or CLM_LINE_THRU_DT = 12/31/9999 then NULL Otherwise CLM_LINE_THRU_DT

    CMS ACO Part A Procedure Files Load
    PerformedEndDate
    MsspPartAProcedureCode.CLM_PRCDR_PRFRM_DT

    If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT

    CMS ACO Part B DME File Load
    PerformedEndDate
    MsspPartBDme.CLM_LINE_THRU_DT

    If CLM_LINE_THRU_DT < 1/1/1753 or CLM_LINE_THRU_DT = 12/31/9999 then NULL Otherwise CLM_LINE_THRU_DT

    CMS ACO Part B Physicians File Load
    PerformedEndDate
    MsspPartBPhysicians.CLM_LINE_THRU_DT

    If CLM_LINE_THRU_DT < 1/1/1753 or CLM_LINE_THRU_DT = 12/31/9999 then NULL Otherwise CLM_LINE_THRU_DT

    CMS CJR DME Claim Procedure Load
    PerformedEndDate
    CmsCjrDmeDetail.EXPNSDT2
    CMS CJR Home Health Claim Procedure Load
    PerformedEndDate
    CmsCjrHomeHealthDetail.REV_DT
    CMS CJR Inpatient Claim Procedure Load
    PerformedEndDate
    CmsCjrInpatientDetail.REV_DT
    CMS CJR Outpatient Claim Procedure Load
    PerformedEndDate
    CmsCjrOutpatientDetail.REV_DT
    CMS CJR Part B Claim Procedure Load
    PerformedEndDate
    CmsCjrPartBDetail.EXPNSDT2
    CMS CJR Skilled Nursing Claim Procedure Load
    PerformedEndDate
    CmsCjrSkilledNursingDetail.REV_DT
    CMS CJR Surgical Procedure Load
    PerformedEndDate
    CmsCjrDiagnosesProcedures.CLM_PRCDR_PRFRM_DT
    Data Aggregation ICD Procedure Load
    PerformedEndDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Data Aggregation Service Line Load
    PerformedEndDate
    AP_CLAIM_PROC.SVC_TO_DATE

    Time Zone: Unspecified

    Externally Adjudicated ICD Procedure Load
    PerformedEndDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Externally Adjudicated Service Line Load
    PerformedEndDate
    AP_CLAIM_PROC.SVC_TO_DATE

    Time Zone: Unspecified

    Payer System ICD Procedure Load
    PerformedEndDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Payer System Service Line Load
    PerformedEndDate
    AP_CLAIM_PROC.SVC_TO_DATE

    Time Zone: Unspecified

    Received Claim ICD Procedure Load
    PerformedEndDate
    AP_CLAIM_ICD_PROC.ICD_PX_DT
    Received Claim Procedure Load
    PerformedEndDate
    AP_CLAIM_PROC.SVC_TO_DATE

    Time Zone: Unspecified

    ReceivedDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReceivedDate

    Not Applicable

    CMS ACO Part A Procedure Files Load
    ReceivedDate

    Not Applicable

    CMS ACO Part B DME File Load
    ReceivedDate

    Not Applicable

    CMS ACO Part B Physicians File Load
    ReceivedDate

    Not Applicable

    CMS CJR DME Claim Procedure Load
    ReceivedDate
    CMS CJR Home Health Claim Procedure Load
    ReceivedDate
    CMS CJR Inpatient Claim Procedure Load
    ReceivedDate
    CMS CJR Outpatient Claim Procedure Load
    ReceivedDate
    CMS CJR Part B Claim Procedure Load
    ReceivedDate
    CMS CJR Skilled Nursing Claim Procedure Load
    ReceivedDate
    CMS CJR Surgical Procedure Load
    ReceivedDate
    Data Aggregation ICD Procedure Load
    ReceivedDate
    AP_CLAIM.DATE_RECEIVED

    AP_CLAIM.DATE_RECEIVED

    Data Aggregation Service Line Load
    ReceivedDate
    AP_CLAIM.DATE_RECEIVED

    AP_CLAIM.DATE_RECEIVED

    Externally Adjudicated ICD Procedure Load
    ReceivedDate

    Not Applicable

    Externally Adjudicated Service Line Load
    ReceivedDate

    Not Applicable

    Payer System ICD Procedure Load
    ReceivedDate
    AP_CLAIM.DATE_RECEIVED

    AP_CLAIM.DATE_RECEIVED

    Payer System Service Line Load
    ReceivedDate
    AP_CLAIM.DATE_RECEIVED

    AP_CLAIM.DATE_RECEIVED

    Received Claim ICD Procedure Load
    ReceivedDate
    AP_CLAIM.DATE_RECEIVED

    AP_CLAIM.DATE_RECEIVED

    Received Claim Procedure Load
    ReceivedDate
    AP_CLAIM.DATE_RECEIVED

    AP_CLAIM.DATE_RECEIVED

    CleanDeniedDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    CleanDeniedDate

    Not Applicable

    CMS ACO Part A Procedure Files Load
    CleanDeniedDate

    Not Applicable

    CMS ACO Part B DME File Load
    CleanDeniedDate

    Not Applicable

    CMS ACO Part B Physicians File Load
    CleanDeniedDate

    Not Applicable

    CMS CJR DME Claim Procedure Load
    CleanDeniedDate
    CMS CJR Home Health Claim Procedure Load
    CleanDeniedDate
    CMS CJR Inpatient Claim Procedure Load
    CleanDeniedDate
    CMS CJR Outpatient Claim Procedure Load
    CleanDeniedDate
    CMS CJR Part B Claim Procedure Load
    CleanDeniedDate
    CMS CJR Skilled Nursing Claim Procedure Load
    CleanDeniedDate
    CMS CJR Surgical Procedure Load
    CleanDeniedDate
    Data Aggregation ICD Procedure Load
    CleanDeniedDate

    Not Applicable

    Data Aggregation Service Line Load
    CleanDeniedDate

    Not Applicable

    Externally Adjudicated ICD Procedure Load
    CleanDeniedDate

    Not Applicable

    Externally Adjudicated Service Line Load
    CleanDeniedDate

    Not Applicable

    Payer System ICD Procedure Load
    CleanDeniedDate

    Not Applicable

    Payer System Service Line Load
    CleanDeniedDate

    Not Applicable

    Received Claim ICD Procedure Load
    CleanDeniedDate
    AP_CLAIM.STATUS_C
    AP_CLAIM.STATUS_DATE

    If AP_CLAIM.STATUS_C = 3-Denied or 4-Clean then AP_CLAIM.STATUS_DATE

    Received Claim Procedure Load
    CleanDeniedDate
    AP_CLAIM.STATUS_C
    AP_CLAIM.STATUS_DATE

    If AP_CLAIM.STATUS_C = 3-Denied or 4-Clean then AP_CLAIM.STATUS_DATE

    PaidDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PaidDate

    Not Applicable

    CMS ACO Part A Procedure Files Load
    PaidDate

    Not Applicable

    CMS ACO Part B DME File Load
    PaidDate

    Not Applicable

    CMS ACO Part B Physicians File Load
    PaidDate

    Not Applicable

    CMS CJR DME Claim Procedure Load
    PaidDate
    CMS CJR Home Health Claim Procedure Load
    PaidDate
    CMS CJR Inpatient Claim Procedure Load
    PaidDate
    CMS CJR Outpatient Claim Procedure Load
    PaidDate
    CMS CJR Part B Claim Procedure Load
    PaidDate
    CMS CJR Skilled Nursing Claim Procedure Load
    PaidDate
    CMS CJR Surgical Procedure Load
    PaidDate
    Data Aggregation ICD Procedure Load
    PaidDate
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded

    Data Aggregation Service Line Load
    PaidDate
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded

    Externally Adjudicated ICD Procedure Load
    PaidDate
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded

    Externally Adjudicated Service Line Load
    PaidDate
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded

    Payer System ICD Procedure Load
    PaidDate
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded

    Payer System Service Line Load
    PaidDate
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded

    Received Claim ICD Procedure Load
    PaidDate
    AP_CHECK.CHECK_ID
    AP_CHECK.POST_DATE
    AP_CLAIM_2.PAID_CHECK_ID
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    If AP_CHECK.POST_DATE is not null then AP_CHECK.POST_DATE Otherwise OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded

    Received Claim Procedure Load
    PaidDate
    AP_CHECK.CHECK_ID
    AP_CHECK.POST_DATE
    AP_CLAIM_2.PAID_CHECK_ID
    OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C
    OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT

    If AP_CHECK.POST_DATE is not null then AP_CHECK.POST_DATE Otherwise OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded

    IsValidInSequenceThroughDateKey

    : integer
    Links to DateDim

    Properties

    Data type
    integer
    SQL Server data type
    bigint
    Allows null
    No
    Default value
    -1
    Delete value
    -3

    AdjustmentType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdjustmentType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartAClaimsHeader.CLM_ADJSMT_TYPE_CD

    If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode"

    CMS ACO Part A Procedure Files Load
    AdjustmentType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartAClaimsHeader.CLM_ADJSMT_TYPE_CD

    If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode"

    CMS ACO Part B DME File Load
    AdjustmentType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartBDme.CLM_ADJSMT_TYPE_CD

    If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode"

    CMS ACO Part B Physicians File Load
    AdjustmentType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartBPhysicians.CLM_ADJSMT_TYPE_CD

    If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode"

    CMS CJR DME Claim Procedure Load
    AdjustmentType

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    AdjustmentType

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    AdjustmentType

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    AdjustmentType

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    AdjustmentType

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    AdjustmentType

    *Not Applicable

    CMS CJR Surgical Procedure Load
    AdjustmentType

    *Not Applicable

    Data Aggregation ICD Procedure Load
    AdjustmentType
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM.TYPE_OF_BILL
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID
    AP_CLAIM_3.LOOP_OR_SPLIT_YN

    If ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original"

    Data Aggregation Service Line Load
    AdjustmentType
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM.TYPE_OF_BILL
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID
    AP_CLAIM_3.LOOP_OR_SPLIT_YN

    If ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original"

    Externally Adjudicated ICD Procedure Load
    AdjustmentType
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM.TYPE_OF_BILL
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID

    If AP_CLAIM.ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if AP_CLAIM_2.CLM_FREQ_CODE_C = 8 then "Cancellation" Otherwise if the right-most character in AP_CLAIM.TYPE_OF_BILL = "8" then "Cancellation" Otherwise if AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then "Adjustment" Otherwise if AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID is not NULL then "Adjustment" Otherwise "Original"

    Externally Adjudicated Service Line Load
    AdjustmentType
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM.TYPE_OF_BILL
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID

    If AP_CLAIM.ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if AP_CLAIM_2.CLM_FREQ_CODE_C = 8 then "Cancellation" Otherwise if the right-most character in AP_CLAIM.TYPE_OF_BILL = "8" then "Cancellation" Otherwise if AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then "Adjustment" Otherwise if AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID is not NULL then "Adjustment" Otherwise "Original"

    Payer System ICD Procedure Load
    AdjustmentType
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM.TYPE_OF_BILL
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID
    AP_CLAIM_3.LOOP_OR_SPLIT_YN

    If ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original"

    Payer System Service Line Load
    AdjustmentType
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM.TYPE_OF_BILL
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID
    AP_CLAIM_3.LOOP_OR_SPLIT_YN

    If ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original"

    Received Claim ICD Procedure Load
    AdjustmentType
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM.TYPE_OF_BILL
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID

    If AP_CLAIM.ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if AP_CLAIM_2.CLM_FREQ_CODE_C = 8 then "Cancellation" Otherwise if the right-most character in AP_CLAIM.TYPE_OF_BILL = "8" then "Cancellation" Otherwise if AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then "Adjustment" Otherwise if AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID is not NULL then "Adjustment" Otherwise "Original"

    Received Claim Procedure Load
    AdjustmentType
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM.TYPE_OF_BILL
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID

    If AP_CLAIM.ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if AP_CLAIM_2.CLM_FREQ_CODE_C = 8 then "Cancellation" Otherwise if the right-most character in AP_CLAIM.TYPE_OF_BILL = "8" then "Cancellation" Otherwise if AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then "Adjustment" Otherwise if AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID is not NULL then "Adjustment" Otherwise "Original"

    AdmissionTypeCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdmissionTypeCode

    MsspPartAClaimsHeader.CLM_ADMSN_TYPE_CD

    CMS ACO Part A Procedure Files Load
    AdmissionTypeCode
    MsspPartAClaimsHeader.CLM_ADMSN_TYPE_CD
    CMS ACO Part B DME File Load
    AdmissionTypeCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AdmissionTypeCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    AdmissionTypeCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    AdmissionTypeCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    AdmissionTypeCode
    CmsCjrInpatientHeader.TYPE_ADM
    CMS CJR Outpatient Claim Procedure Load
    AdmissionTypeCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    AdmissionTypeCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    AdmissionTypeCode
    CmsCjrSkilledNursingHeader.TYPE_ADM
    CMS CJR Surgical Procedure Load
    AdmissionTypeCode
    CmsCjrInpatientHeader.TYPE_ADM
    CmsCjrSkilledNursingHeader.TYPE_ADM

    If the claim is inpatient or skilled nursing then TYPE_ADM Otherwise *Not Applicable

    Data Aggregation ICD Procedure Load
    AdmissionTypeCode
    AP_CLAIM.ADMISSION_TYPE_C
    CLM_VALUES_2.ADMSN_TYP

    If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C

    Data Aggregation Service Line Load
    AdmissionTypeCode
    AP_CLAIM.ADMISSION_TYPE_C
    CLM_VALUES_2.ADMSN_TYP

    If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C

    Externally Adjudicated ICD Procedure Load
    AdmissionTypeCode
    AP_CLAIM.ADMISSION_TYPE_C
    CLM_VALUES_2.ADMSN_TYP

    If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C

    Externally Adjudicated Service Line Load
    AdmissionTypeCode
    AP_CLAIM.ADMISSION_TYPE_C
    CLM_VALUES_2.ADMSN_TYP

    If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C

    Payer System ICD Procedure Load
    AdmissionTypeCode
    AP_CLAIM.ADMISSION_TYPE_C
    CLM_VALUES_2.ADMSN_TYP

    If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C

    Payer System Service Line Load
    AdmissionTypeCode
    AP_CLAIM.ADMISSION_TYPE_C
    CLM_VALUES_2.ADMSN_TYP

    If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C

    Received Claim ICD Procedure Load
    AdmissionTypeCode
    AP_CLAIM.ADMISSION_TYPE_C
    CLM_VALUES_2.ADMSN_TYP

    If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C

    Received Claim Procedure Load
    AdmissionTypeCode
    AP_CLAIM.ADMISSION_TYPE_C
    CLM_VALUES_2.ADMSN_TYP

    If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C

    AdmissionType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdmissionType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartAClaimsHeader.CLM_ADMSN_TYPE_CD

    If CLM_ADMSN_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdmissionTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdmissionTypeCode"

    CMS ACO Part A Procedure Files Load
    AdmissionType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartAClaimsHeader.CLM_ADMSN_TYPE_CD

    If CLM_ADMSN_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdmissionTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdmissionTypeCode"

    CMS ACO Part B DME File Load
    AdmissionType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AdmissionType

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    AdmissionType

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    AdmissionType

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    AdmissionType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrInpatientHeader.TYPE_ADM

    If TYPE_ADM is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimAdmissionTypeCode then *Unknown Otherwise Name where CategoryName = ClaimAdmissionTypeCode

    CMS CJR Outpatient Claim Procedure Load
    AdmissionType

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    AdmissionType

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    AdmissionType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrSkilledNursingHeader.TYPE_ADM

    If TYPE_ADM is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimAdmissionTypeCode then *Unknown Otherwise Name where CategoryName = ClaimAdmissionTypeCode

    CMS CJR Surgical Procedure Load
    AdmissionType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrInpatientHeader.TYPE_ADM
    CmsCjrSkilledNursingHeader.TYPE_ADM

    If the claim is inpatient or skilled nursing:

    If TYPE_ADM is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimAdmissionTypeCode then *Unknown Otherwise Name where CategoryName = ClaimAdmissionTypeCode

    Otherwise if the claim is Part B or hospice then *Not Applicable

    Data Aggregation ICD Procedure Load
    AdmissionType
    AP_CLAIM.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.NAME

    If AP_CLAIM.ADMISSION_TYPE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then *Unknown Otherwise NAME

    Data Aggregation Service Line Load
    AdmissionType
    AP_CLAIM.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.NAME

    If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME

    Externally Adjudicated ICD Procedure Load
    AdmissionType
    AP_CLAIM.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.NAME

    If AP_CLAIM.ADMISSION_TYPE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then *Unknown Otherwise NAME

    Externally Adjudicated Service Line Load
    AdmissionType
    AP_CLAIM.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.NAME

    If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME

    Payer System ICD Procedure Load
    AdmissionType
    AP_CLAIM.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.NAME

    If AP_CLAIM.ADMISSION_TYPE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then *Unknown Otherwise NAME

    Payer System Service Line Load
    AdmissionType
    AP_CLAIM.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.NAME

    If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME

    Received Claim ICD Procedure Load
    AdmissionType
    AP_CLAIM.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.NAME

    If AP_CLAIM.ADMISSION_TYPE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then *Unknown Otherwise NAME

    Received Claim Procedure Load
    AdmissionType
    AP_CLAIM.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.ADMISSION_TYPE_C
    ZC_MC_ADM_TYPE.NAME

    If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME

    AdmissionSourceCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdmissionSourceCode
    MsspPartAClaimsHeader.CLM_ADMSN_SRC_CD
    CMS ACO Part A Procedure Files Load
    AdmissionSourceCode
    MsspPartAClaimsHeader.CLM_ADMSN_SRC_CD
    CMS ACO Part B DME File Load
    AdmissionSourceCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AdmissionSourceCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    AdmissionSourceCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    AdmissionSourceCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    AdmissionSourceCode
    CmsCjrInpatientHeader.SRC_ADMS
    CMS CJR Outpatient Claim Procedure Load
    AdmissionSourceCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    AdmissionSourceCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    AdmissionSourceCode
    CmsCjrSkilledNursingHeader.SRC_ADMS
    CMS CJR Surgical Procedure Load
    AdmissionSourceCode
    CmsCjrInpatientHeader.SRC_ADMS
    CmsCjrSkilledNursingHeader.SRC_ADMS

    If the claim is inpatient or skilled nursing then SRC_ADMS Otherwise *Not Applicable

    Data Aggregation ICD Procedure Load
    AdmissionSourceCode
    CLM_VALUES_2.ADMSN_SRC
    ZC_MC_ADM_SOURCE.ABBR

    If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR

    Data Aggregation Service Line Load
    AdmissionSourceCode
    CLM_VALUES_2.ADMSN_SRC
    ZC_MC_ADM_SOURCE.ABBR

    If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR

    Externally Adjudicated ICD Procedure Load
    AdmissionSourceCode
    CLM_VALUES_2.ADMSN_SRC
    ZC_MC_ADM_SOURCE.ABBR

    If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR

    Externally Adjudicated Service Line Load
    AdmissionSourceCode
    CLM_VALUES_2.ADMSN_SRC
    ZC_MC_ADM_SOURCE.ABBR

    If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR

    Payer System ICD Procedure Load
    AdmissionSourceCode
    CLM_VALUES_2.ADMSN_SRC
    ZC_MC_ADM_SOURCE.ABBR

    If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR

    Payer System Service Line Load
    AdmissionSourceCode
    CLM_VALUES_2.ADMSN_SRC
    ZC_MC_ADM_SOURCE.ABBR

    If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR

    Received Claim ICD Procedure Load
    AdmissionSourceCode
    CLM_VALUES_2.ADMSN_SRC
    ZC_MC_ADM_SOURCE.ABBR

    If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR

    Received Claim Procedure Load
    AdmissionSourceCode
    CLM_VALUES_2.ADMSN_SRC
    ZC_MC_ADM_SOURCE.ABBR

    If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR

    AdmissionSource

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdmissionSource
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartAClaimsHeader.CLM_ADMSN_SRC_CD
    MsspPartAClaimsHeader.CLM_ADMSN_TYPE_CD

    If CLM_ADMSN_SRC_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CLM_ADMSN_TYPE_CD = 4-Newborn and CategoryName = "ClaimAdmissionSourceCodeNewborn" then "*Unknown" Otherwise if Id is NULL where CategoryName = "ClaimAdmissionSourceCode" then "*Unknown" Otherwise if CLM_ADMSN_TYPE_CD = 4-Newborn then Name where CategoryName = "ClaimAdmissionSourceCodeNewborn" Otherwise Name where CategoryName = "ClaimAdmissionSourceCode"

    CMS ACO Part A Procedure Files Load
    AdmissionSource
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartAClaimsHeader.CLM_ADMSN_SRC_CD
    MsspPartAClaimsHeader.CLM_ADMSN_TYPE_CD

    If CLM_ADMSN_SRC_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CLM_ADMSN_TYPE_CD = 4-Newborn and CategoryName = "ClaimAdmissionSourceCodeNewborn" then "*Unknown" Otherwise if Id is NULL where CategoryName = "ClaimAdmissionSourceCode" then "*Unknown" Otherwise if CLM_ADMSN_TYPE_CD = 4-Newborn then Name where CategoryName = "ClaimAdmissionSourceCodeNewborn" Otherwise Name where CategoryName = "ClaimAdmissionSourceCode"

    CMS ACO Part B DME File Load
    AdmissionSource

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AdmissionSource

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    AdmissionSource

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    AdmissionSource

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    AdmissionSource
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrInpatientHeader.SRC_ADMS
    CmsCjrInpatientHeader.TYPE_ADM

    If SRC_ADMS is NULL then *Unspecified Otherwise if Id is NULL where TYPE_ADM = 4-Newborn and CategoryName = ClaimAdmissionSourceCodeNewborn then *Unknown Otherwise if Id is NULL where CategoryName = ClaimAdmissionSourceCode then *Unknown Otherwise if TYPE_ADM = 4-Newborn then Name where CategoryName = ClaimAdmissionSourceCodeNewborn Otherwise Name where CategoryName = ClaimAdmissionSourceCode

    CMS CJR Outpatient Claim Procedure Load
    AdmissionSource

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    AdmissionSource

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    AdmissionSource
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrSkilledNursingHeader.SRC_ADMS
    CmsCjrSkilledNursingHeader.TYPE_ADM

    If SRC_ADMS is NULL then *Unspecified Otherwise if Id is NULL where TYPE_ADM = 4-Newborn and CategoryName = ClaimAdmissionSourceCodeNewborn then *Unknown Otherwise if Id is NULL where CategoryName = ClaimAdmissionSourceCode then *Unknown Otherwise if TYPE_ADM = 4-Newborn then Name where CategoryName = ClaimAdmissionSourceCodeNewborn Otherwise Name where CategoryName = ClaimAdmissionSourceCode

    CMS CJR Surgical Procedure Load
    AdmissionSource
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrInpatientHeader.SRC_ADMS
    CmsCjrInpatientHeader.TYPE_ADM
    CmsCjrSkilledNursingHeader.SRC_ADMS
    CmsCjrSkilledNursingHeader.TYPE_ADM

    If the claim is inpatient or skilled nursing:

    If SRC_ADMS is NULL then *Unspecified Otherwise if Id is NULL where TYPE_ADM = 4-Newborn and CategoryName = ClaimAdmissionSourceCodeNewborn then *Unknown Otherwise if Id is NULL where CategoryName = ClaimAdmissionSourceCode then *Unknown Otherwise if TYPE_ADM = 4-Newborn then Name where CategoryName = ClaimAdmissionSourceCodeNewborn Otherwise Name where CategoryName = ClaimAdmissionSourceCode

    Otherwise if the claim is Part B or hospice then *Not Applicable

    Data Aggregation ICD Procedure Load
    AdmissionSource
    AP_CLAIM.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.NAME

    If AP_CLAIM.ADMISSION_SOURCE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then *Unknown Otherwise NAME

    Data Aggregation Service Line Load
    AdmissionSource
    AP_CLAIM.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.NAME

    If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME

    Externally Adjudicated ICD Procedure Load
    AdmissionSource
    AP_CLAIM.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.NAME

    If AP_CLAIM.ADMISSION_SOURCE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then *Unknown Otherwise NAME

    Externally Adjudicated Service Line Load
    AdmissionSource
    AP_CLAIM.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.NAME

    If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME

    Payer System ICD Procedure Load
    AdmissionSource
    AP_CLAIM.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.NAME

    If AP_CLAIM.ADMISSION_SOURCE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then *Unknown Otherwise NAME

    Payer System Service Line Load
    AdmissionSource
    AP_CLAIM.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.NAME

    If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME

    Received Claim ICD Procedure Load
    AdmissionSource
    AP_CLAIM.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.NAME

    If AP_CLAIM.ADMISSION_SOURCE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then *Unknown Otherwise NAME

    Received Claim Procedure Load
    AdmissionSource
    AP_CLAIM.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C
    ZC_MC_ADM_SOURCE.NAME

    If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME

    DenialReason

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DenialReason

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    DenialReason

    "*Not Applicable"

    CMS ACO Part B DME File Load
    DenialReason
    CmsDenialTypeCodes.CategoryName
    CmsDenialTypeCodes.Id
    CmsDenialTypeCodes.IsDenial
    CmsDenialTypeCodes.Name
    MsspPartBDme.CLM_PRCSG_IND_CD

    If CLM_PRCSG_IND_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimLineProcessingIndicatorCode" then "*Unknown" Otherwise if IsDenial = 0 then "*Not Applicable" Otherwise Name where CategoryName = "ClaimLineProcessingIndicatorCode"

    CMS ACO Part B Physicians File Load
    DenialReason
    CmsDenialTypeCodes.CategoryName
    CmsDenialTypeCodes.Id
    CmsDenialTypeCodes.IsDenial
    CmsDenialTypeCodes.Name
    MsspPartBPhysicians.CLM_PRCSG_IND_CD

    If CLM_PRCSG_IND_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimLineProcessingIndicatorCode" then "*Unknown" Otherwise if IsDenial = 0 then "*Not Applicable" Otherwise Name where CategoryName = "ClaimLineProcessingIndicatorCode"

    CMS CJR DME Claim Procedure Load
    DenialReason

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    DenialReason

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    DenialReason

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    DenialReason

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    DenialReason

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    DenialReason

    *Not Applicable

    CMS CJR Surgical Procedure Load
    DenialReason

    *Not Applicable

    Data Aggregation Service Line Load
    DenialReason
    AP_CLAIM.STATUS_C
    SVC_LN_INFO_3.PRCS_IND_CD_DESC

    IF PRCS_IND_CD is not null and PRCS_IND_CD_DESC is null then *Unknown Otherwise if PRCS_IND_CD_DESC is not null then PRCS_IND_CD_DESC Otherwise if STATUS_C = 3 then "Denied" Otherwise "*Not Applicable"

    Externally Adjudicated ICD Procedure Load
    DenialReason
    AP_CLAIM.STATUS_C
    CLM_VALUES_5.CARRIER_PAYMENT_DNL_CD
    CLM_VALUES_5.CARRIER_PAYMENT_DNL_DESC
    CLM_VALUES_5.NON_PAYMENT_RSN_CD
    CLM_VALUES_5.NON_PAYMENT_RSN_DESC

    If CLM_VALUES_5.NON_PAYMENT_RSN_CD is not null and CLM_VALUES_5.NON_PAYMENT_RSN_DESC is null then ''*Unknown''' Otherwise if CLM_VALUES_5.CARRIER_PAYMENT_DNL_CD is not null and CLM_VALUES_5.CARRIER_PAYMENT_DNL_DESC is null then ''*Unknown''' Otherwise if CLM_VALUES_5.NON_PAYMENT_RSN_DESC is not null then CLM_VALUES_5.NON_PAYMENT_RSN_CD' Otherwise if CLM_VALUES_5.CARRIER_PAYMENT_DNL_DESC is not null then CLM_VALUES_5.CARRIER_PAYMENT_DNL_DESC' Otherwise if STATUS_C = 3 - Denied then "Denied" Otherwise "*Not Applicable"

    Externally Adjudicated Service Line Load
    DenialReason
    AP_CLAIM.STATUS_C
    SVC_LN_INFO_3.PRCS_IND_CD
    SVC_LN_INFO_3.PRCS_IND_CD_DESC

    If SVC_LN_INFO_3.PRCS_IND_CD is not null and SVC_LN_INFO_3.PRCS_IND_CD_DESC is null then ''*Unknown''' Otherwise if SVC_LN_INFO_3.PRCS_IND_CD_DESC is not null then SVC_LN_INFO_3.PRCS_IND_CD_DESC' Otherwise if STATUS_C = 3 - Denied then "Denied" Otherwise "*Not Applicable"

    Payer System Service Line Load
    DenialReason
    AP_CLAIM.STATUS_C
    SVC_LN_INFO_3.PRCS_IND_CD_DESC

    IF PRCS_IND_CD is not null and PRCS_IND_CD_DESC is null then *Unknown Otherwise if PRCS_IND_CD_DESC is not null then PRCS_IND_CD_DESC Otherwise if STATUS_C = 3 then "Denied" Otherwise "*Not Applicable"

    Received Claim ICD Procedure Load
    DenialReason
    AP_CLAIM.STATUS_C

    If STATUS_C = 3 - Denied then Denied Otherwise *Not Applicable

    Received Claim Procedure Load
    DenialReason
    AP_CLAIM.STATUS_C

    If STATUS_C = 3 - Denied then Denied Otherwise "*Not Applicable"

    DrgType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DrgType

    This column isn't configured for use in reports. See an administrator for more information.

    CMS ACO Part A Procedure Files Load
    DrgType

    This column isn't configured for use in reports. See an administrator for more information.

    CMS ACO Part B DME File Load
    DrgType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    DrgType

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    DrgType

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    DrgType

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    DrgType

    This column isn't configured for use in reports. See an administrator for more information.

    CMS CJR Outpatient Claim Procedure Load
    DrgType

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    DrgType

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    DrgType

    This column isn't configured for use in reports. See an administrator for more information.

    CMS CJR Surgical Procedure Load
    DrgType

    If the claim is inpatient or skilled nursing then *Unspecified Otherwise If the claim is Part B or hospice then *Not Applicable

    Data Aggregation ICD Procedure Load
    DrgType
    AP_CLAIM_3.DRG_ID_TYPE_ID
    IDENTITY_ID_TYPE.ID_TYPE_NAME

    If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified"

    Data Aggregation Service Line Load
    DrgType
    AP_CLAIM_3.DRG_ID_TYPE_ID
    IDENTITY_ID_TYPE.ID_TYPE_NAME

    If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified"

    Externally Adjudicated ICD Procedure Load
    DrgType
    AP_CLAIM_3.DRG_ID_TYPE_ID
    IDENTITY_ID_TYPE.ID_TYPE_NAME

    If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified"

    Externally Adjudicated Service Line Load
    DrgType
    AP_CLAIM_3.DRG_ID_TYPE_ID
    IDENTITY_ID_TYPE.ID_TYPE_NAME

    If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified"

    Payer System ICD Procedure Load
    DrgType
    AP_CLAIM_3.DRG_ID_TYPE_ID
    IDENTITY_ID_TYPE.ID_TYPE_NAME

    If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified"

    Payer System Service Line Load
    DrgType
    AP_CLAIM_3.DRG_ID_TYPE_ID
    IDENTITY_ID_TYPE.ID_TYPE_NAME

    If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified"

    Received Claim ICD Procedure Load
    DrgType
    AP_CLAIM_3.DRG_ID_TYPE_ID
    IDENTITY_ID_TYPE.ID_TYPE_NAME

    If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified"

    Received Claim Procedure Load
    DrgType
    AP_CLAIM_3.DRG_ID_TYPE_ID
    IDENTITY_ID_TYPE.ID_TYPE_NAME

    If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified"

    DrgCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DrgCode
    MsspPartAClaimsHeader.DGNS_DRG_CD
    CMS ACO Part A Procedure Files Load
    DrgCode
    MsspPartAClaimsHeader.DGNS_DRG_CD
    CMS ACO Part B DME File Load
    DrgCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    DrgCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    DrgCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    DrgCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    DrgCode
    CmsCjrInpatientHeader.DRG_CD
    CMS CJR Outpatient Claim Procedure Load
    DrgCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    DrgCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    DrgCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    DrgCode
    CmsCjrInpatientHeader.DRG_CD
    CmsCjrSkilledNursingHeader.DRG_CD

    If the claim is inpatient or skilled nursing then DRG_CD Otherwise *Not Applicable

    Data Aggregation ICD Procedure Load
    DrgCode
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID
    CLARITY_DRG_MPI_ID.MPI_ID

    If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID

    Data Aggregation Service Line Load
    DrgCode
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID
    CLARITY_DRG_MPI_ID.MPI_ID

    If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID

    Externally Adjudicated ICD Procedure Load
    DrgCode
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID
    CLARITY_DRG_MPI_ID.MPI_ID

    If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID

    Externally Adjudicated Service Line Load
    DrgCode
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID
    CLARITY_DRG_MPI_ID.MPI_ID

    If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID

    Payer System ICD Procedure Load
    DrgCode
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID
    CLARITY_DRG_MPI_ID.MPI_ID

    If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID

    Payer System Service Line Load
    DrgCode
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID
    CLARITY_DRG_MPI_ID.MPI_ID

    If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID

    Received Claim ICD Procedure Load
    DrgCode
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID
    CLARITY_DRG_MPI_ID.MPI_ID

    If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID

    Received Claim Procedure Load
    DrgCode
    AP_CLAIM.DRG_ID
    AP_CLAIM_3.DRG_ID_TYPE_ID
    CLARITY_DRG_MPI_ID.MPI_ID

    If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID

    IsDrg

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0
    Delete value
    0
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsDrg

    0

    CMS ACO Part A Procedure Files Load
    IsDrg

    0

    CMS ACO Part B DME File Load
    IsDrg

    0

    CMS ACO Part B Physicians File Load
    IsDrg

    0

    CMS CJR DME Claim Procedure Load
    IsDrg
    CMS CJR Home Health Claim Procedure Load
    IsDrg
    CMS CJR Inpatient Claim Procedure Load
    IsDrg
    CMS CJR Outpatient Claim Procedure Load
    IsDrg
    CMS CJR Part B Claim Procedure Load
    IsDrg
    CMS CJR Skilled Nursing Claim Procedure Load
    IsDrg
    CMS CJR Surgical Procedure Load
    IsDrg
    Data Aggregation ICD Procedure Load
    IsDrg

    0

    Data Aggregation Service Line Load
    IsDrg
    AP_CLAIM_PROC.TX_TYPE_C

    If TX_TYPE_C = 6 - AP Claim DRG Tx then 1 Otherwise 0

    Externally Adjudicated ICD Procedure Load
    IsDrg

    0

    Externally Adjudicated Service Line Load
    IsDrg
    AP_CLAIM_PROC.TX_TYPE_C

    If TX_TYPE_C = 6 - AP Claim DRG Tx then 1 Otherwise 0

    Payer System ICD Procedure Load
    IsDrg

    0

    Payer System Service Line Load
    IsDrg
    AP_CLAIM_PROC.TX_TYPE_C

    If TX_TYPE_C = 6 - AP Claim DRG Tx then 1 Otherwise 0

    Received Claim ICD Procedure Load
    IsDrg

    0

    Received Claim Procedure Load
    IsDrg
    AP_CLAIM_PROC.TX_TYPE_C

    If TX_TYPE_C = 6 - AP Claim DRG Tx then 1 Otherwise 0

    IsServicePricedByDrg

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0
    Delete value
    0
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsServicePricedByDrg

    0

    CMS ACO Part A Procedure Files Load
    IsServicePricedByDrg

    0

    CMS ACO Part B DME File Load
    IsServicePricedByDrg

    0

    CMS ACO Part B Physicians File Load
    IsServicePricedByDrg

    0

    CMS CJR DME Claim Procedure Load
    IsServicePricedByDrg
    CMS CJR Home Health Claim Procedure Load
    IsServicePricedByDrg
    CMS CJR Inpatient Claim Procedure Load
    IsServicePricedByDrg
    CMS CJR Outpatient Claim Procedure Load
    IsServicePricedByDrg
    CMS CJR Part B Claim Procedure Load
    IsServicePricedByDrg
    CMS CJR Skilled Nursing Claim Procedure Load
    IsServicePricedByDrg
    CMS CJR Surgical Procedure Load
    IsServicePricedByDrg
    Data Aggregation ICD Procedure Load
    IsServicePricedByDrg

    0

    Data Aggregation Service Line Load
    IsServicePricedByDrg
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.DRG_PRICING_YN
    AP_CLAIM_PROC.CLAIM_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_PROC.TX_TYPE_C
    AP_CLAIM_PROC_3.REDISTRIBUTED_TO_TX_ID

    If DRG_PRICING_YN is NULL then 0 Otherwise if DRG_PRICING_YN = 'N' then 0 Otherwise if TX_TYPE_C = 6 then 0 Otherwise if REDISTRIBUTED_TO_TX_ID is NULL then 1 Otherwise if the transaction pointed to by REDISTRIBUTED_TO_TX_ID is on the same claim and has TX_TYPE_C = 6 then 1 Otherwise 0

    Externally Adjudicated ICD Procedure Load
    IsServicePricedByDrg

    0

    Externally Adjudicated Service Line Load
    IsServicePricedByDrg
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.DRG_PRICING_YN
    AP_CLAIM_PROC.CLAIM_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_PROC.TX_TYPE_C
    AP_CLAIM_PROC_3.REDISTRIBUTED_TO_TX_ID

    If DRG_PRICING_YN is NULL then 0 Otherwise if DRG_PRICING_YN = 'N' then 0 Otherwise if TX_TYPE_C = 6 then 0 Otherwise if REDISTRIBUTED_TO_TX_ID is NULL then 1 Otherwise if the transaction pointed to by REDISTRIBUTED_TO_TX_ID is on the same claim and has TX_TYPE_C = 6 then 1 Otherwise 0

    Payer System ICD Procedure Load
    IsServicePricedByDrg

    0

    Payer System Service Line Load
    IsServicePricedByDrg
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.DRG_PRICING_YN
    AP_CLAIM_PROC.CLAIM_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_PROC.TX_TYPE_C
    AP_CLAIM_PROC_3.REDISTRIBUTED_TO_TX_ID

    If DRG_PRICING_YN is NULL then 0 Otherwise if DRG_PRICING_YN = 'N' then 0 Otherwise if TX_TYPE_C = 6 then 0 Otherwise if REDISTRIBUTED_TO_TX_ID is NULL then 1 Otherwise if the transaction pointed to by REDISTRIBUTED_TO_TX_ID is on the same claim and has TX_TYPE_C = 6 then 1 Otherwise 0

    Received Claim ICD Procedure Load
    IsServicePricedByDrg

    0

    Received Claim Procedure Load
    IsServicePricedByDrg
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.DRG_PRICING_YN
    AP_CLAIM_PROC.CLAIM_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_PROC.TX_TYPE_C
    AP_CLAIM_PROC_3.REDISTRIBUTED_TO_TX_ID

    If DRG_PRICING_YN is NULL then 0 Otherwise if DRG_PRICING_YN = 'N' then 0 Otherwise if TX_TYPE_C = 6 then 0 Otherwise if REDISTRIBUTED_TO_TX_ID is NULL then 1 Otherwise if the transaction pointed to by REDISTRIBUTED_TO_TX_ID is on the same claim and has TX_TYPE_C = 6 then 1 Otherwise 0

    DischargeDispositionCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DischargeDispositionCode
    MsspPartAClaimsHeader.BENE_PTNT_STUS_CD
    CMS ACO Part A Procedure Files Load
    DischargeDispositionCode
    MsspPartAClaimsHeader.BENE_PTNT_STUS_CD
    CMS ACO Part B DME File Load
    DischargeDispositionCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    DischargeDispositionCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    DischargeDispositionCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    DischargeDispositionCode
    CmsCjrHomeHealthHeader.STUS_CD
    CMS CJR Inpatient Claim Procedure Load
    DischargeDispositionCode
    CmsCjrInpatientHeader.STUS_CD
    CMS CJR Outpatient Claim Procedure Load
    DischargeDispositionCode
    CmsCjrOutpatientHeader.STUS_CD
    CMS CJR Part B Claim Procedure Load
    DischargeDispositionCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    DischargeDispositionCode
    CmsCjrSkilledNursingHeader.STUS_CD
    CMS CJR Surgical Procedure Load
    DischargeDispositionCode
    CmsCjrHospiceHeader.STUS_CD
    CmsCjrInpatientHeader.STUS_CD
    CmsCjrSkilledNursingHeader.STUS_CD

    If the claim is inpatient, skilled nursing, or hospice then STUS_CD Otherwise *Not Applicable

    Data Aggregation ICD Procedure Load
    DischargeDispositionCode
    AP_CLAIM.PAT_STATUS_C
    CLM_VALUES_2.DISCHRG_DISP

    If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C

    Data Aggregation Service Line Load
    DischargeDispositionCode
    AP_CLAIM.PAT_STATUS_C
    CLM_VALUES_2.DISCHRG_DISP

    If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C

    Externally Adjudicated ICD Procedure Load
    DischargeDispositionCode
    AP_CLAIM.PAT_STATUS_C
    CLM_VALUES_2.DISCHRG_DISP

    If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C

    Externally Adjudicated Service Line Load
    DischargeDispositionCode
    AP_CLAIM.PAT_STATUS_C
    CLM_VALUES_2.DISCHRG_DISP

    If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C

    Payer System ICD Procedure Load
    DischargeDispositionCode
    AP_CLAIM.PAT_STATUS_C
    CLM_VALUES_2.DISCHRG_DISP

    If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C

    Payer System Service Line Load
    DischargeDispositionCode
    AP_CLAIM.PAT_STATUS_C
    CLM_VALUES_2.DISCHRG_DISP

    If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C

    Received Claim ICD Procedure Load
    DischargeDispositionCode
    AP_CLAIM.PAT_STATUS_C
    CLM_VALUES_2.DISCHRG_DISP

    If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C

    Received Claim Procedure Load
    DischargeDispositionCode
    AP_CLAIM.PAT_STATUS_C
    CLM_VALUES_2.DISCHRG_DISP

    If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C

    DischargeDisposition

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DischargeDisposition
    CmsCategoryList.BeneficiaryPatientStatusCode
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartAClaimsHeader.BENE_PTNT_STUS_CD

    If BENE_PTNT_STUS_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "BeneficiaryPatientStatusCode" then "*Unknown" Otherwise Name where CategoryName = "BeneficiaryPatientStatusCode"

    CMS ACO Part A Procedure Files Load
    DischargeDisposition
    CmsCategoryList.BeneficiaryPatientStatusCode
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartAClaimsHeader.BENE_PTNT_STUS_CD

    If BENE_PTNT_STUS_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "BeneficiaryPatientStatusCode" then "*Unknown" Otherwise Name where CategoryName = "BeneficiaryPatientStatusCode"

    CMS ACO Part B DME File Load
    DischargeDisposition

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    DischargeDisposition

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    DischargeDisposition

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    DischargeDisposition
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrHomeHealthHeader.STUS_CD

    If STUS_CD is NULL then *Unspecified If Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name

    CMS CJR Inpatient Claim Procedure Load
    DischargeDisposition
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrInpatientHeader.STUS_CD

    If STUS_CD is NULL then *Unspecified If Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name

    CMS CJR Outpatient Claim Procedure Load
    DischargeDisposition
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrOutpatientHeader.STUS_CD

    If STUS_CD is NULL then *Unspecified If Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name

    CMS CJR Part B Claim Procedure Load
    DischargeDisposition

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    DischargeDisposition
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrSkilledNursingHeader.STUS_CD

    If STUS_CD is NULL then *Unspecified If Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name

    CMS CJR Surgical Procedure Load
    DischargeDisposition
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrHospiceHeader.STUS_CD
    CmsCjrInpatientHeader.STUS_CD
    CmsCjrSkilledNursingHeader.STUS_CD

    If the claim is inpatient, skilled nursing, or hospice:

    If STUS_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name where CategoryName = BeneficiaryPatientStatusCode

    Otherwise if the claim is Part B then *Not Applicable

    Data Aggregation ICD Procedure Load
    DischargeDisposition
    AP_CLAIM.PAT_STATUS_C
    ZC_MC_PAT_STATUS.NAME
    ZC_MC_PAT_STATUS.PAT_STATUS_C

    If AP_CLAIM.PAT_STATUS_C is NULL then *Unspecified Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then *Unknown Otherwise NAME

    Data Aggregation Service Line Load
    DischargeDisposition
    AP_CLAIM.PAT_STATUS_C
    ZC_MC_PAT_STATUS.NAME
    ZC_MC_PAT_STATUS.PAT_STATUS_C
    Externally Adjudicated ICD Procedure Load
    DischargeDisposition
    AP_CLAIM.PAT_STATUS_C
    ZC_MC_PAT_STATUS.NAME
    ZC_MC_PAT_STATUS.PAT_STATUS_C

    If AP_CLAIM.PAT_STATUS_C is NULL then *Unspecified Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then *Unknown Otherwise NAME

    Externally Adjudicated Service Line Load
    DischargeDisposition
    AP_CLAIM.PAT_STATUS_C
    ZC_MC_PAT_STATUS.NAME
    ZC_MC_PAT_STATUS.PAT_STATUS_C

    If AP_CLAIM.PAT_STATUS_C is NULL then "*Unspecified" Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then "*Unknown" Otherwise NAME

    Payer System ICD Procedure Load
    DischargeDisposition
    AP_CLAIM.PAT_STATUS_C
    ZC_MC_PAT_STATUS.NAME
    ZC_MC_PAT_STATUS.PAT_STATUS_C

    If AP_CLAIM.PAT_STATUS_C is NULL then *Unspecified Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then *Unknown Otherwise NAME

    Payer System Service Line Load
    DischargeDisposition
    AP_CLAIM.PAT_STATUS_C
    ZC_MC_PAT_STATUS.NAME
    ZC_MC_PAT_STATUS.PAT_STATUS_C

    If AP_CLAIM.PAT_STATUS_C is NULL then "*Unspecified" Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then "*Unknown" Otherwise NAME

    Received Claim ICD Procedure Load
    DischargeDisposition
    AP_CLAIM.PAT_STATUS_C
    ZC_MC_PAT_STATUS.NAME
    ZC_MC_PAT_STATUS.PAT_STATUS_C

    If AP_CLAIM.PAT_STATUS_C is NULL then *Unspecified Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then *Unknown Otherwise NAME

    Received Claim Procedure Load
    DischargeDisposition
    AP_CLAIM.PAT_STATUS_C
    ZC_MC_PAT_STATUS.NAME
    ZC_MC_PAT_STATUS.PAT_STATUS_C

    If AP_CLAIM.PAT_STATUS_C is NULL then "*Unspecified" Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then "*Unknown" Otherwise NAME

    InterpretedClaimDetailType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(100)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    InterpretedClaimDetailType

    NULL

    CMS ACO Part A Procedure Files Load
    InterpretedClaimDetailType

    NULL

    CMS ACO Part B DME File Load
    InterpretedClaimDetailType

    NULL

    CMS ACO Part B Physicians File Load
    InterpretedClaimDetailType

    NULL

    CMS CJR DME Claim Procedure Load
    InterpretedClaimDetailType

    NULL

    CMS CJR Home Health Claim Procedure Load
    InterpretedClaimDetailType

    NULL

    CMS CJR Inpatient Claim Procedure Load
    InterpretedClaimDetailType

    NULL

    CMS CJR Outpatient Claim Procedure Load
    InterpretedClaimDetailType

    NULL

    CMS CJR Part B Claim Procedure Load
    InterpretedClaimDetailType

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    InterpretedClaimDetailType

    NULL

    CMS CJR Surgical Procedure Load
    InterpretedClaimDetailType

    NULL

    Data Aggregation ICD Procedure Load
    InterpretedClaimDetailType

    NULL

    Data Aggregation Service Line Load
    InterpretedClaimDetailType

    NULL

    Externally Adjudicated ICD Procedure Load
    InterpretedClaimDetailType

    NULL

    Externally Adjudicated Service Line Load
    InterpretedClaimDetailType

    NULL

    Payer System ICD Procedure Load
    InterpretedClaimDetailType

    NULL

    Payer System Service Line Load
    InterpretedClaimDetailType

    NULL

    Received Claim ICD Procedure Load
    InterpretedClaimDetailType

    NULL

    Received Claim Procedure Load
    InterpretedClaimDetailType

    NULL

    RevenueCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RevenueCode
    MsspPartAClaimsDetail.CLM_LINE_PROD_REV_CTR_CD
    CMS ACO Part A Procedure Files Load
    RevenueCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    RevenueCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    RevenueCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    RevenueCode

    NotApplicable

    CMS CJR Home Health Claim Procedure Load
    RevenueCode
    CmsCjrHomeHealthDetail.REV_CTR
    CMS CJR Inpatient Claim Procedure Load
    RevenueCode
    CmsCjrInpatientDetail.REV_CTR
    CMS CJR Outpatient Claim Procedure Load
    RevenueCode
    CmsCjrOutpatientDetail.REV_CTR
    CMS CJR Part B Claim Procedure Load
    RevenueCode

    NotApplicable

    CMS CJR Skilled Nursing Claim Procedure Load
    RevenueCode
    CmsCjrSkilledNursingDetail.REV_CTR
    CMS CJR Surgical Procedure Load
    RevenueCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    RevenueCode

    *Not Applicable

    Data Aggregation Service Line Load
    RevenueCode
    CL_UB_REV_CODE.REVENUE_CODE
    SVC_LN_INFO.LN_REV_CD

    If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise if the number of services has not been modified in the system then LN_REV_CD

    Externally Adjudicated ICD Procedure Load
    RevenueCode

    *Not Applicable

    Externally Adjudicated Service Line Load
    RevenueCode
    CL_UB_REV_CODE.REVENUE_CODE
    SVC_LN_INFO.LN_REV_CD

    If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise LN_REV_CD

    Payer System ICD Procedure Load
    RevenueCode

    *Not Applicable

    Payer System Service Line Load
    RevenueCode
    CL_UB_REV_CODE.REVENUE_CODE
    SVC_LN_INFO.LN_REV_CD

    If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise if the number of services has not been modified in the system then LN_REV_CD

    Received Claim ICD Procedure Load
    RevenueCode

    *Not Applicable

    Received Claim Procedure Load
    RevenueCode
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CL_UB_REV_CODE.REVENUE_CODE
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REV_CD

    If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise if the number of services has not been modified in the system then LN_REV_CD

    ProcedureCodeType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ProcedureCodeType
    MsspPartAClaimsDetail.CLM_LINE_PROD_REV_CTR_CD

    "HippsCode" if CLM_LINE_PROD_REV_CTR_CD is 0022, 0023, or 0024; otherwise "HcpcsCode"

    CMS ACO Part A Procedure Files Load
    ProcedureCodeType
    MsspPartAProcedureCode.DGNS_PRCDR_ICD_IND
    MsspPartAProcedureCode.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-PCS" Otherwise "Unknown Code Type"

    CMS ACO Part B DME File Load
    ProcedureCodeType

    "HcpcsCode"

    CMS ACO Part B Physicians File Load
    ProcedureCodeType

    "HcpcsCode"

    CMS CJR DME Claim Procedure Load
    ProcedureCodeType

    HcpcsCode

    CMS CJR Home Health Claim Procedure Load
    ProcedureCodeType

    HcpcsCode

    CMS CJR Inpatient Claim Procedure Load
    ProcedureCodeType

    HcpcsCode

    CMS CJR Outpatient Claim Procedure Load
    ProcedureCodeType

    HcpcsCode

    CMS CJR Part B Claim Procedure Load
    ProcedureCodeType

    HcpcsCode

    CMS CJR Skilled Nursing Claim Procedure Load
    ProcedureCodeType

    HcpcsCode

    CMS CJR Surgical Procedure Load
    ProcedureCodeType
    CmsCjrHospiceHeader.CLM_THRU_DT
    CmsCjrHospiceHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.CLM_THRU_DT
    CmsCjrInpatientHeader.DGNS_PRCDR_ICD_IND
    CmsCjrInpatientHeader.DSCHRGDT
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.CLM_THRU_DT
    CmsCjrSkilledNursingHeader.DGNS_PRCDR_ICD_IND
    CmsCjrSkilledNursingHeader.DSCHRGDT

    If claim is inpatient or skilled nursing:

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-PCS Otherwise Unspecified

    Otherwise if the claim is Part B or hospice:

    If no CODE_VALUE for this claim where CLM_PROD_TYPE_CD = S-Procedure exists then HcpcsCode Otherwise If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-PCS Otherwise Unspecified

    Data Aggregation ICD Procedure Load
    ProcedureCodeType
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    CL_ICD_PX.REF_BILL_CODE_SET_C
    ZC_HCD_CODE_SET.CODE_SET_C
    ZC_HCD_CODE_SET.NAME

    If REF_BILL_CODE_SET_C is NULL then *Unspecified Otherwise if REF_BILL_CODE_SET_C = 1 - ICD-9-CM Volume 3 then ICD-9-CM Otherwise if REF_BILL_CODE_SET_C = 2 - ICD-10-PCS then ICD-10-PCS Otherwise if CODE_SET_C is NULL then *Unknown Otherwise NAME

    Data Aggregation Service Line Load
    ProcedureCodeType
    CLARITY_EAP_OT.CODE_TYPE_C
    CLARITY_EAP_OT.CPT_CODE
    CLARITY_EAP_OT.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If CODE_TYPE_C = 1 or 2 then "HcpcsCode" Otherwise if CODE_TYPE_C is NULL and PROC_ID is not NULL then "HcpcsCode" Otherwise if CPT_CODE is not NULL then "OtherCode" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then 'HcpcsCode' Otherwise if LN_PROC_QUAL = "HP" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then 'HippsCode'

    Externally Adjudicated ICD Procedure Load
    ProcedureCodeType
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    CL_ICD_PX.REF_BILL_CODE_SET_C
    ZC_HCD_CODE_SET.CODE_SET_C
    ZC_HCD_CODE_SET.NAME

    If REF_BILL_CODE_SET_C is NULL then *Unspecified Otherwise if REF_BILL_CODE_SET_C = 1 - ICD-9-CM Volume 3 then ICD-9-CM Otherwise if REF_BILL_CODE_SET_C = 2 - ICD-10-PCS then ICD-10-PCS Otherwise if CODE_SET_C is NULL then *Unknown Otherwise NAME

    Externally Adjudicated Service Line Load
    ProcedureCodeType
    CLARITY_EAP_OT.CODE_TYPE_C
    CLARITY_EAP_OT.CPT_CODE
    CLARITY_EAP_OT.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If CODE_TYPE_C = 1 - CPT(R) or 2 - HCPCS or NULL for PROC_ID then "HcpcsCode" Otherwise if PROC_ID is not NULL then "OtherCode" Otherwise "HcpcsCode"

    Payer System ICD Procedure Load
    ProcedureCodeType
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    CL_ICD_PX.REF_BILL_CODE_SET_C
    ZC_HCD_CODE_SET.CODE_SET_C
    ZC_HCD_CODE_SET.NAME

    If REF_BILL_CODE_SET_C is NULL then *Unspecified Otherwise if REF_BILL_CODE_SET_C = 1 - ICD-9-CM Volume 3 then ICD-9-CM Otherwise if REF_BILL_CODE_SET_C = 2 - ICD-10-PCS then ICD-10-PCS Otherwise if CODE_SET_C is NULL then *Unknown Otherwise NAME

    Payer System Service Line Load
    ProcedureCodeType
    CLARITY_EAP_OT.CODE_TYPE_C
    CLARITY_EAP_OT.CPT_CODE
    CLARITY_EAP_OT.PROC_ID
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If CODE_TYPE_C = 1 or 2 then "HcpcsCode" Otherwise if CODE_TYPE_C is NULL and PROC_ID is not NULL then "HcpcsCode" Otherwise if CPT_CODE is not NULL then "OtherCode" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then 'HcpcsCode' Otherwise if LN_PROC_QUAL = "HP" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then 'HippsCode'

    Received Claim ICD Procedure Load
    ProcedureCodeType
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    CL_ICD_PX.REF_BILL_CODE_SET_C
    ZC_HCD_CODE_SET.CODE_SET_C
    ZC_HCD_CODE_SET.NAME

    If REF_BILL_CODE_SET_C is NULL then *Unspecified Otherwise if REF_BILL_CODE_SET_C = 1 - ICD-9-CM Volume 3 then ICD-9-CM Otherwise if REF_BILL_CODE_SET_C = 2 - ICD-10-PCS then ICD-10-PCS Otherwise if CODE_SET_C is NULL then *Unknown Otherwise NAME

    Received Claim Procedure Load
    ProcedureCodeType
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLARITY_EAP_OT.CODE_TYPE_C
    CLARITY_EAP_OT.CPT_CODE
    CLARITY_EAP_OT.PROC_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If CODE_TYPE_C = 1 or 2 then "HcpcsCode" Otherwise if CODE_TYPE_C is NULL and PROC_ID is not NULL then "HcpcsCode" Otherwise if CPT_CODE is not NULL then "OtherCode" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then 'HcpcsCode' Otherwise if LN_PROC_QUAL = "HP" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then 'HippsCode'

    ProcedureCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ProcedureCode
    MsspPartAClaimsDetail.CLM_LINE_HCPCS_CD
    CMS ACO Part A Procedure Files Load
    ProcedureCode
    MsspPartAProcedureCode.CLM_PRCDR_CD
    CMS ACO Part B DME File Load
    ProcedureCode
    MsspPartBDme.CLM_LINE_HCPCS_CD
    CMS ACO Part B Physicians File Load
    ProcedureCode
    MsspPartBPhysicians.CLM_LINE_HCPCS_CD
    CMS CJR DME Claim Procedure Load
    ProcedureCode
    CmsCjrDmeDetail.HCPCS_CD
    CMS CJR Home Health Claim Procedure Load
    ProcedureCode
    CmsCjrHomeHealthDetail.HCPCS_CD
    CMS CJR Inpatient Claim Procedure Load
    ProcedureCode
    CmsCjrInpatientDetail.HCPCS_CD
    CMS CJR Outpatient Claim Procedure Load
    ProcedureCode
    CmsCjrOutpatientDetail.HCPCS_CD
    CMS CJR Part B Claim Procedure Load
    ProcedureCode
    CmsCjrPartBDetail.HCPCS_CD
    CMS CJR Skilled Nursing Claim Procedure Load
    ProcedureCode
    CmsCjrSkilledNursingDetail.HCPCS_CD
    CMS CJR Surgical Procedure Load
    ProcedureCode
    CmsCjrDiagnosesProcedures.CODE_VALUE
    Data Aggregation ICD Procedure Load
    ProcedureCode
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    CL_ICD_PX.REF_BILL_CODE
    Data Aggregation Service Line Load
    ProcedureCode
    CLARITY_EAP_OT.CPT_CODE
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If CPT_CODE for PROC_ID is not NULL the CPT_CODE Otherwise if LN_PROC_QUAL = "HC" or "HP" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD

    Externally Adjudicated ICD Procedure Load
    ProcedureCode
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    CL_ICD_PX.REF_BILL_CODE
    Externally Adjudicated Service Line Load
    ProcedureCode
    AP_CLAIM_PROC.PROC_ID
    CLARITY_EAP_OT.CPT_CODE
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If CPT_CODE for PROC_ID is not NULL the CPT_CODE Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then LN_PROC_CD

    Payer System ICD Procedure Load
    ProcedureCode
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    CL_ICD_PX.REF_BILL_CODE
    Payer System Service Line Load
    ProcedureCode
    CLARITY_EAP_OT.CPT_CODE
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If CPT_CODE for PROC_ID is not NULL the CPT_CODE Otherwise if LN_PROC_QUAL = "HC" or "HP" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD

    Received Claim ICD Procedure Load
    ProcedureCode
    AP_CLAIM_ICD_PROC.ICD_PX_ID
    CL_ICD_PX.REF_BILL_CODE
    Received Claim Procedure Load
    ProcedureCode
    AP_CLAIM_PROC.PROC_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLARITY_EAP_OT.CPT_CODE
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_CD
    SVC_LN_INFO.LN_PROC_QUAL

    If CPT_CODE for PROC_ID is not NULL the CPT_CODE Otherwise if LN_PROC_QUAL = "HC" or "HP" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD

    PlaceOfServiceType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PlaceOfServiceType

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    PlaceOfServiceType

    "*Not Applicable"

    CMS ACO Part B DME File Load
    PlaceOfServiceType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartBDme.CLM_POS_CD

    If CLM_POS_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "PlaceOfServiceCode" then "*Unknown" Otherwise Name where CategoryName = "PlaceOfServiceCode"

    CMS ACO Part B Physicians File Load
    PlaceOfServiceType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartBPhysicians.CLM_POS_CD

    If CLM_POS_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "PlaceOfServiceCode" then "*Unknown" Otherwise Name where CategoryName = "PlaceOfServiceCode"

    CMS CJR DME Claim Procedure Load
    PlaceOfServiceType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrDmeDetail.PLCSRVC

    If PLCSRVC is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = PlaceOfServiceCode then *Unknown Otherwise Name where CategoryName = PlaceOfServiceCode

    CMS CJR Home Health Claim Procedure Load
    PlaceOfServiceType

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    PlaceOfServiceType

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    PlaceOfServiceType

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    PlaceOfServiceType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrPartBDetail.PLCSRVC

    If PLCSRVC is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = PlaceOfServiceCode then *Unknown Otherwise Name where CategoryName = PlaceOfServiceCode

    CMS CJR Skilled Nursing Claim Procedure Load
    PlaceOfServiceType

    *Not Applicable

    CMS CJR Surgical Procedure Load
    PlaceOfServiceType

    *Not Applicable

    Data Aggregation ICD Procedure Load
    PlaceOfServiceType

    *Not Applicable

    Data Aggregation Service Line Load
    PlaceOfServiceType
    AP_CLAIM_PROC.POS_TYPE_C
    ZC_POS_TYPE.NAME
    ZC_POS_TYPE.POS_TYPE_C

    If AP_CLAIM_PROC.POS_TYPE_C IS NULL THEN "*Unspecified" Otherwise if ZC_POS_TYPE.POS_TYPE_C IS NULL THEN "*Unknown" Otherwise NAME

    Externally Adjudicated ICD Procedure Load
    PlaceOfServiceType

    *Not Applicable

    Externally Adjudicated Service Line Load
    PlaceOfServiceType
    AP_CLAIM_PROC.POS_TYPE_C
    ZC_POS_TYPE.NAME
    ZC_POS_TYPE.POS_TYPE_C

    If AP_CLAIM_PROC.POS_TYPE_C IS NULL THEN "*Unspecified" Otherwise if ZC_POS_TYPE.POS_TYPE_C IS NULL THEN "*Unknown" Otherwise NAME

    Payer System ICD Procedure Load
    PlaceOfServiceType

    *Not Applicable

    Payer System Service Line Load
    PlaceOfServiceType
    AP_CLAIM_PROC.POS_TYPE_C
    ZC_POS_TYPE.NAME
    ZC_POS_TYPE.POS_TYPE_C

    If AP_CLAIM_PROC.POS_TYPE_C IS NULL THEN "*Unspecified" Otherwise if ZC_POS_TYPE.POS_TYPE_C IS NULL THEN "*Unknown" Otherwise NAME

    Received Claim ICD Procedure Load
    PlaceOfServiceType

    *Not Applicable

    Received Claim Procedure Load
    PlaceOfServiceType
    AP_CLAIM_PROC.POS_TYPE_C
    ZC_POS_TYPE.NAME
    ZC_POS_TYPE.POS_TYPE_C

    If AP_CLAIM_PROC.POS_TYPE_C IS NULL THEN "*Unspecified" Otherwise if ZC_POS_TYPE.POS_TYPE_C IS NULL THEN "*Unknown" Otherwise NAME

    ServiceType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceType

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    ServiceType

    "*Not Applicable"

    CMS ACO Part B DME File Load
    ServiceType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartBDme.CLM_FED_TYPE_SRVC_CD

    If CLM_FED_TYPE_SRVC_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "FederalTypeServiceCode" then "*Unknown" Otherwise Name where CategoryName = "FederalTypeServiceCode"

    CMS ACO Part B Physicians File Load
    ServiceType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartBPhysicians.CLM_FED_TYPE_SRVC_CD

    If CLM_FED_TYPE_SRVC_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "FederalTypeServiceCode" then "*Unknown" Otherwise Name where CategoryName = "FederalTypeServiceCode"

    CMS CJR DME Claim Procedure Load
    ServiceType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrDmeDetail.TYPSRVCB

    If TYPSRVCB is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = FederalTypeServiceCode then *Unknown Otherwise Name where CategoryName = FederalTypeServiceCode

    CMS CJR Home Health Claim Procedure Load
    ServiceType

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    ServiceType

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    ServiceType

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    ServiceType
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrPartBDetail.TYPSRVCB

    If TYPSRVCB is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = FederalTypeServiceCode then *Unknown Otherwise Name where CategoryName = FederalTypeServiceCode

    CMS CJR Skilled Nursing Claim Procedure Load
    ServiceType

    *Not Applicable

    CMS CJR Surgical Procedure Load
    ServiceType

    *Not Applicable

    Data Aggregation ICD Procedure Load
    ServiceType

    *Not Applicable

    Externally Adjudicated ICD Procedure Load
    ServiceType

    *Not Applicable

    Externally Adjudicated Service Line Load
    ServiceType

    NULL

    Payer System ICD Procedure Load
    ServiceType

    *Not Applicable

    Received Claim ICD Procedure Load
    ServiceType

    *Not Applicable

    Received Claim Procedure Load
    ServiceType
    AP_CLAIM_PROC.TYPE_OF_SERVICE_C
    ZC_TYPE_OF_SERVICE.NAME
    ZC_TYPE_OF_SERVICE.TYPE_OF_SERVICE_C

    If AP_CLAIM_PROC.TYPE_OF_SERVICE_C IS NULL THEN "*Unspecified" Otherwise if ZC_TYPE_OF_SERVICE.TYPE_OF_SERVICE_C IS NULL THEN "*Unknown" Otherwise NAME

    TypeOfBillCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TypeOfBillCode
    MsspPartAClaimsHeader.CLM_BILL_CLSFCTN_CD
    MsspPartAClaimsHeader.CLM_BILL_FAC_TYPE_CD
    MsspPartAClaimsHeader.CLM_BILL_FREQ_CD

    Concatenation of CLM_BILL_FAC_TYPE_CD, CLM_BILL_CLSFCTN_CD, and CLM_BILL_FREQ_CD

    CMS ACO Part A Procedure Files Load
    TypeOfBillCode
    MsspPartAClaimsHeader.CLM_BILL_CLSFCTN_CD
    MsspPartAClaimsHeader.CLM_BILL_FAC_TYPE_CD
    MsspPartAClaimsHeader.CLM_BILL_FREQ_CD

    Concatenation of CLM_BILL_FAC_TYPE_CD, CLM_BILL_CLSFCTN_CD, and CLM_BILL_FREQ_CD

    CMS ACO Part B DME File Load
    TypeOfBillCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    TypeOfBillCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    TypeOfBillCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    TypeOfBillCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    TypeOfBillCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    TypeOfBillCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    TypeOfBillCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    TypeOfBillCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    TypeOfBillCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    TypeOfBillCode
    AP_CLAIM.TYPE_OF_BILL
    Data Aggregation Service Line Load
    TypeOfBillCode
    AP_CLAIM.TYPE_OF_BILL
    Externally Adjudicated ICD Procedure Load
    TypeOfBillCode
    AP_CLAIM.TYPE_OF_BILL
    Externally Adjudicated Service Line Load
    TypeOfBillCode
    AP_CLAIM.TYPE_OF_BILL
    Payer System ICD Procedure Load
    TypeOfBillCode
    AP_CLAIM.TYPE_OF_BILL
    Payer System Service Line Load
    TypeOfBillCode
    AP_CLAIM.TYPE_OF_BILL
    Received Claim ICD Procedure Load
    TypeOfBillCode
    AP_CLAIM.TYPE_OF_BILL
    Received Claim Procedure Load
    TypeOfBillCode
    AP_CLAIM.TYPE_OF_BILL

    FirstModifier

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FirstModifier
    MsspPartAClaimsDetail.HCPCS_1_MDFR_CD
    CMS ACO Part A Procedure Files Load
    FirstModifier

    "*Not Applicable"

    CMS ACO Part B DME File Load
    FirstModifier

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FirstModifier
    MsspPartBPhysicians.HCPCS_1_MDFR_CD
    CMS CJR DME Claim Procedure Load
    FirstModifier
    CmsCjrDmeDetail.MDFR_CD1
    CMS CJR Home Health Claim Procedure Load
    FirstModifier
    CmsCjrHomeHealthDetail.MDFR_CD1
    CMS CJR Inpatient Claim Procedure Load
    FirstModifier
    CmsCjrInpatientDetail.MDFR_CD1
    CMS CJR Outpatient Claim Procedure Load
    FirstModifier
    CmsCjrOutpatientDetail.MDFR_CD1
    CMS CJR Part B Claim Procedure Load
    FirstModifier
    CmsCjrPartBDetail.MDFR_CD1
    CMS CJR Skilled Nursing Claim Procedure Load
    FirstModifier
    CmsCjrSkilledNursingDetail.MDFR_CD1
    CMS CJR Surgical Procedure Load
    FirstModifier

    *Not Applicable

    Data Aggregation ICD Procedure Load
    FirstModifier

    *Not Applicable

    Data Aggregation Service Line Load
    FirstModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then first modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the first modifier in the comma delimited list of LN_PROC_MOD

    Externally Adjudicated ICD Procedure Load
    FirstModifier

    *Not Applicable

    Externally Adjudicated Service Line Load
    FirstModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then first modifier in the comma delimited list of MODIFIERS Otherwise the first modifier in the comma delimited list of LN_PROC_MOD

    Payer System ICD Procedure Load
    FirstModifier

    *Not Applicable

    Payer System Service Line Load
    FirstModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then first modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the first modifier in the comma delimited list of LN_PROC_MOD

    Received Claim ICD Procedure Load
    FirstModifier

    *Not Applicable

    Received Claim Procedure Load
    FirstModifier
    AP_CLAIM_PROC.MODIFIERS
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then first modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the first modifier in the comma delimited list of LN_PROC_MOD

    SecondModifier

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SecondModifier
    MsspPartAClaimsDetail.HCPCS_2_MDFR_CD
    CMS ACO Part A Procedure Files Load
    SecondModifier

    "*Not Applicable"

    CMS ACO Part B DME File Load
    SecondModifier

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    SecondModifier
    MsspPartBPhysicians.HCPCS_2_MDFR_CD
    CMS CJR DME Claim Procedure Load
    SecondModifier
    CmsCjrDmeDetail.MDFR_CD2
    CMS CJR Home Health Claim Procedure Load
    SecondModifier
    CmsCjrHomeHealthDetail.MDFR_CD2
    CMS CJR Inpatient Claim Procedure Load
    SecondModifier
    CmsCjrInpatientDetail.MDFR_CD2
    CMS CJR Outpatient Claim Procedure Load
    SecondModifier
    CmsCjrOutpatientDetail.MDFR_CD2
    CMS CJR Part B Claim Procedure Load
    SecondModifier
    CmsCjrPartBDetail.MDFR_CD2
    CMS CJR Skilled Nursing Claim Procedure Load
    SecondModifier
    CmsCjrSkilledNursingDetail.MDFR_CD2
    CMS CJR Surgical Procedure Load
    SecondModifier

    *Not Applicable

    Data Aggregation ICD Procedure Load
    SecondModifier

    *Not Applicable

    Data Aggregation Service Line Load
    SecondModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then second modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the second modifier in the comma delimited list of LN_PROC_MOD

    Externally Adjudicated ICD Procedure Load
    SecondModifier

    *Not Applicable

    Externally Adjudicated Service Line Load
    SecondModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then second modifier in the comma delimited list of MODIFIERS Otherwise the second modifier in the comma delimited list of LN_PROC_MOD

    Payer System ICD Procedure Load
    SecondModifier

    *Not Applicable

    Payer System Service Line Load
    SecondModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then second modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the second modifier in the comma delimited list of LN_PROC_MOD

    Received Claim ICD Procedure Load
    SecondModifier

    *Not Applicable

    Received Claim Procedure Load
    SecondModifier
    AP_CLAIM_PROC.MODIFIERS
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then second modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the second modifier in the comma delimited list of LN_PROC_MOD

    ThirdModifier

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ThirdModifier
    MsspPartAClaimsDetail.HCPCS_3_MDFR_CD
    CMS ACO Part A Procedure Files Load
    ThirdModifier

    "*Not Applicable"

    CMS ACO Part B DME File Load
    ThirdModifier

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ThirdModifier
    MsspPartBPhysicians.HCPCS_3_MDFR_CD
    CMS CJR DME Claim Procedure Load
    ThirdModifier

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    ThirdModifier

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    ThirdModifier

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    ThirdModifier

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    ThirdModifier
    CmsCjrPartBDetail.MDFR_CD3
    CMS CJR Skilled Nursing Claim Procedure Load
    ThirdModifier

    *Not Applicable

    CMS CJR Surgical Procedure Load
    ThirdModifier

    *Not Applicable

    Data Aggregation ICD Procedure Load
    ThirdModifier

    *Not Applicable

    Data Aggregation Service Line Load
    ThirdModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then third modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the third modifier in the comma delimited list of LN_PROC_MOD

    Externally Adjudicated ICD Procedure Load
    ThirdModifier

    *Not Applicable

    Externally Adjudicated Service Line Load
    ThirdModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then third modifier in the comma delimited list of MODIFIERS Otherwise the third modifier in the comma delimited list of LN_PROC_MOD

    Payer System ICD Procedure Load
    ThirdModifier

    *Not Applicable

    Payer System Service Line Load
    ThirdModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then third modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the third modifier in the comma delimited list of LN_PROC_MOD

    Received Claim ICD Procedure Load
    ThirdModifier

    *Not Applicable

    Received Claim Procedure Load
    ThirdModifier
    AP_CLAIM_PROC.MODIFIERS
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then third modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the third modifier in the comma delimited list of LN_PROC_MOD

    FourthModifier

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FourthModifier
    MsspPartAClaimsDetail.HCPCS_4_MDFR_CD
    CMS ACO Part A Procedure Files Load
    FourthModifier

    "*Not Applicable"

    CMS ACO Part B DME File Load
    FourthModifier

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FourthModifier
    MsspPartBPhysicians.HCPCS_4_MDFR_CD
    CMS CJR DME Claim Procedure Load
    FourthModifier

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    FourthModifier

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    FourthModifier

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    FourthModifier

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    FourthModifier
    CmsCjrPartBDetail.MDFR_CD4
    CMS CJR Skilled Nursing Claim Procedure Load
    FourthModifier

    *Not Applicable

    CMS CJR Surgical Procedure Load
    FourthModifier

    *Not Applicable

    Data Aggregation ICD Procedure Load
    FourthModifier

    *Not Applicable

    Data Aggregation Service Line Load
    FourthModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then fourth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the fourth modifier in the comma delimited list of LN_PROC_MOD

    Externally Adjudicated ICD Procedure Load
    FourthModifier

    *Not Applicable

    Externally Adjudicated Service Line Load
    FourthModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then fourth modifier in the comma delimited list of MODIFIERS Otherwise the fourth modifier in the comma delimited list of LN_PROC_MOD

    Payer System ICD Procedure Load
    FourthModifier

    *Not Applicable

    Payer System Service Line Load
    FourthModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then fourth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the fourth modifier in the comma delimited list of LN_PROC_MOD

    Received Claim ICD Procedure Load
    FourthModifier

    *Not Applicable

    Received Claim Procedure Load
    FourthModifier
    AP_CLAIM_PROC.MODIFIERS
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then fourth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the fourth modifier in the comma delimited list of LN_PROC_MOD

    FifthModifier

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FifthModifier
    MsspPartAClaimsDetail.HCPCS_5_MDFR_CD
    CMS ACO Part A Procedure Files Load
    FifthModifier

    "*Not Applicable"

    CMS ACO Part B DME File Load
    FifthModifier

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FifthModifier
    MsspPartBPhysicians.HCPCS_5_MDFR_CD
    CMS CJR DME Claim Procedure Load
    FifthModifier

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    FifthModifier

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    FifthModifier

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    FifthModifier

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    FifthModifier
    CmsCjrPartBDetail.MDFR_CD5
    CMS CJR Skilled Nursing Claim Procedure Load
    FifthModifier

    *Not Applicable

    CMS CJR Surgical Procedure Load
    FifthModifier

    *Not Applicable

    Data Aggregation ICD Procedure Load
    FifthModifier

    *Not Applicable

    Data Aggregation Service Line Load
    FifthModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then fifth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the fifth modifier in the comma delimited list of LN_PROC_MOD

    Externally Adjudicated ICD Procedure Load
    FifthModifier

    *Not Applicable

    Externally Adjudicated Service Line Load
    FifthModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then fifth modifier in the comma delimited list of MODIFIERS Otherwise the fifth modifier in the comma delimited list of LN_PROC_MOD

    Payer System ICD Procedure Load
    FifthModifier

    *Not Applicable

    Payer System Service Line Load
    FifthModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then fifth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the fifth modifier in the comma delimited list of LN_PROC_MOD

    Received Claim ICD Procedure Load
    FifthModifier

    *Not Applicable

    Received Claim Procedure Load
    FifthModifier
    AP_CLAIM_PROC.MODIFIERS
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then fifth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the fifth modifier in the comma delimited list of LN_PROC_MOD

    SixthModifier

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SixthModifier

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    SixthModifier

    "*Not Applicable"

    CMS ACO Part B DME File Load
    SixthModifier

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    SixthModifier

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    SixthModifier

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    SixthModifier

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    SixthModifier

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    SixthModifier

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    SixthModifier

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    SixthModifier

    *Not Applicable

    CMS CJR Surgical Procedure Load
    SixthModifier

    *Not Applicable

    Data Aggregation ICD Procedure Load
    SixthModifier

    *Not Applicable

    Data Aggregation Service Line Load
    SixthModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then sixth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the sixth modifier in the comma delimited list of LN_PROC_MOD

    Externally Adjudicated ICD Procedure Load
    SixthModifier

    *Not Applicable

    Externally Adjudicated Service Line Load
    SixthModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then sixth modifier in the comma delimited list of MODIFIERS Otherwise the sixth modifier in the comma delimited list of LN_PROC_MOD

    Payer System ICD Procedure Load
    SixthModifier

    *Not Applicable

    Payer System Service Line Load
    SixthModifier
    AP_CLAIM_PROC.MODIFIERS
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then sixth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the sixth modifier in the comma delimited list of LN_PROC_MOD

    Received Claim ICD Procedure Load
    SixthModifier

    *Not Applicable

    Received Claim Procedure Load
    SixthModifier
    AP_CLAIM_PROC.MODIFIERS
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_PROC_MOD

    If MODIFIERS is not NULL then sixth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the sixth modifier in the comma delimited list of LN_PROC_MOD

    FirstDiagnosisType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FirstDiagnosisType

    If MsspPartADiagnosisCode.FirstDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FirstDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type"

    CMS ACO Part A Procedure Files Load
    FirstDiagnosisType

    If MsspPartADiagnosisCode.FirstDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FirstDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type"

    CMS ACO Part B DME File Load
    FirstDiagnosisType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FirstDiagnosisType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type"

    CMS CJR DME Claim Procedure Load
    FirstDiagnosisType
    CmsCjrDmeHeader.CLM_THRU_DT
    CmsCjrDmeHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    CMS CJR Home Health Claim Procedure Load
    FirstDiagnosisType

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    FirstDiagnosisType

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    FirstDiagnosisType
    CmsCjrOutpatientDetail.PDGNS_CD
    CmsCjrOutpatientHeader.CLM_THRU_DT
    CmsCjrOutpatientHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    CMS CJR Part B Claim Procedure Load
    FirstDiagnosisType
    CmsCjrPartBHeader.CLM_THRU_DT
    CmsCjrPartBHeader.DGNS_PRCDR_ICD_IND

    If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified

    CMS CJR Skilled Nursing Claim Procedure Load
    FirstDiagnosisType

    *Not Applicable

    CMS CJR Surgical Procedure Load
    FirstDiagnosisType

    *Not Applicable

    Data Aggregation ICD Procedure Load
    FirstDiagnosisType

    *Not Applicable

    Data Aggregation Service Line Load
    FirstDiagnosisType
    AP_PROC_ASSOC_DX.DX_RANK
    ZC_EDG_CODE_SET.NAME
    Externally Adjudicated ICD Procedure Load
    FirstDiagnosisType

    *Not Applicable

    Externally Adjudicated Service Line Load
    FirstDiagnosisType
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 1 then NAME

    Payer System ICD Procedure Load
    FirstDiagnosisType

    *Not Applicable

    Payer System Service Line Load
    FirstDiagnosisType
    AP_PROC_ASSOC_DX.DX_RANK
    ZC_EDG_CODE_SET.NAME
    Received Claim ICD Procedure Load
    FirstDiagnosisType

    *Not Applicable

    Received Claim Procedure Load
    FirstDiagnosisType
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 1 then NAME

    FirstDiagnosisCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FirstDiagnosisCode

    MsspPartADiagnosisCode.FirstDiagnosisCode

    CMS ACO Part A Procedure Files Load
    FirstDiagnosisCode

    MsspPartADiagnosisCode.FirstDiagnosisCode

    CMS ACO Part B DME File Load
    FirstDiagnosisCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FirstDiagnosisCode
    MsspPartBPhysicians.CLM_DGNS_1_CD
    CMS CJR DME Claim Procedure Load
    FirstDiagnosisCode
    CmsCjrDmeDetail.DGNS_CD
    CMS CJR Home Health Claim Procedure Load
    FirstDiagnosisCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    FirstDiagnosisCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    FirstDiagnosisCode
    CmsCjrOutpatientDetail.PDGNS_CD
    CMS CJR Part B Claim Procedure Load
    FirstDiagnosisCode
    CmsCjrPartBDetail.DGNS_CD
    CMS CJR Skilled Nursing Claim Procedure Load
    FirstDiagnosisCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    FirstDiagnosisCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    FirstDiagnosisCode

    *Not Applicable

    Data Aggregation Service Line Load
    FirstDiagnosisCode
    AP_PROC_ASSOC_DX.DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Externally Adjudicated ICD Procedure Load
    FirstDiagnosisCode

    *Not Applicable

    Externally Adjudicated Service Line Load
    FirstDiagnosisCode
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 1

    Payer System ICD Procedure Load
    FirstDiagnosisCode

    *Not Applicable

    Payer System Service Line Load
    FirstDiagnosisCode
    AP_PROC_ASSOC_DX.DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Received Claim ICD Procedure Load
    FirstDiagnosisCode

    *Not Applicable

    Received Claim Procedure Load
    FirstDiagnosisCode
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 1

    SecondDiagnosisType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SecondDiagnosisType

    If MsspPartADiagnosisCode.SecondDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If SecondDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type"

    CMS ACO Part A Procedure Files Load
    SecondDiagnosisType

    If MsspPartADiagnosisCode.SecondDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If SecondDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type"

    CMS ACO Part B DME File Load
    SecondDiagnosisType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    SecondDiagnosisType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type"

    CMS CJR DME Claim Procedure Load
    SecondDiagnosisType

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    SecondDiagnosisType

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    SecondDiagnosisType

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    SecondDiagnosisType

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    SecondDiagnosisType

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    SecondDiagnosisType

    *Not Applicable

    CMS CJR Surgical Procedure Load
    SecondDiagnosisType

    *Not Applicable

    Data Aggregation ICD Procedure Load
    SecondDiagnosisType

    *Not Applicable

    Data Aggregation Service Line Load
    SecondDiagnosisType
    AP_PROC_ASSOC_DX.DX_RANK
    ZC_EDG_CODE_SET.NAME
    Externally Adjudicated ICD Procedure Load
    SecondDiagnosisType

    *Not Applicable

    Externally Adjudicated Service Line Load
    SecondDiagnosisType
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 2 then NAME

    Payer System ICD Procedure Load
    SecondDiagnosisType

    *Not Applicable

    Payer System Service Line Load
    SecondDiagnosisType
    AP_PROC_ASSOC_DX.DX_RANK
    ZC_EDG_CODE_SET.NAME
    Received Claim ICD Procedure Load
    SecondDiagnosisType

    *Not Applicable

    Received Claim Procedure Load
    SecondDiagnosisType
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 2 then NAME

    SecondDiagnosisCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SecondDiagnosisCode

    MsspPartADiagnosisCode.SecondDiagnosisCode

    CMS ACO Part A Procedure Files Load
    SecondDiagnosisCode

    MsspPartADiagnosisCode.SecondDiagnosisCode

    CMS ACO Part B DME File Load
    SecondDiagnosisCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    SecondDiagnosisCode
    MsspPartBPhysicians.CLM_DGNS_2_CD
    CMS CJR DME Claim Procedure Load
    SecondDiagnosisCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    SecondDiagnosisCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    SecondDiagnosisCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    SecondDiagnosisCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    SecondDiagnosisCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    SecondDiagnosisCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    SecondDiagnosisCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    SecondDiagnosisCode

    *Not Applicable

    Data Aggregation Service Line Load
    SecondDiagnosisCode
    AP_PROC_ASSOC_DX.DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Externally Adjudicated ICD Procedure Load
    SecondDiagnosisCode

    *Not Applicable

    Externally Adjudicated Service Line Load
    SecondDiagnosisCode
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 2

    Payer System ICD Procedure Load
    SecondDiagnosisCode

    *Not Applicable

    Payer System Service Line Load
    SecondDiagnosisCode
    AP_PROC_ASSOC_DX.DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Received Claim ICD Procedure Load
    SecondDiagnosisCode

    *Not Applicable

    Received Claim Procedure Load
    SecondDiagnosisCode
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 2

    ThirdDiagnosisType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ThirdDiagnosisType

    If MsspPartADiagnosisCode.ThirdDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If ThirdDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type"

    CMS ACO Part A Procedure Files Load
    ThirdDiagnosisType

    If MsspPartADiagnosisCode.ThirdDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If ThirdDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type"

    CMS ACO Part B DME File Load
    ThirdDiagnosisType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ThirdDiagnosisType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type"

    CMS CJR DME Claim Procedure Load
    ThirdDiagnosisType

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    ThirdDiagnosisType

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    ThirdDiagnosisType

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    ThirdDiagnosisType

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    ThirdDiagnosisType

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    ThirdDiagnosisType

    *Not Applicable

    CMS CJR Surgical Procedure Load
    ThirdDiagnosisType

    *Not Applicable

    Data Aggregation ICD Procedure Load
    ThirdDiagnosisType

    *Not Applicable

    Data Aggregation Service Line Load
    ThirdDiagnosisType
    AP_PROC_ASSOC_DX.DX_RANK
    ZC_EDG_CODE_SET.NAME
    Externally Adjudicated ICD Procedure Load
    ThirdDiagnosisType

    *Not Applicable

    Externally Adjudicated Service Line Load
    ThirdDiagnosisType
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 3 then NAME

    Payer System ICD Procedure Load
    ThirdDiagnosisType

    *Not Applicable

    Payer System Service Line Load
    ThirdDiagnosisType
    AP_PROC_ASSOC_DX.DX_RANK
    ZC_EDG_CODE_SET.NAME
    Received Claim ICD Procedure Load
    ThirdDiagnosisType

    *Not Applicable

    Received Claim Procedure Load
    ThirdDiagnosisType
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 3 then NAME

    ThirdDiagnosisCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ThirdDiagnosisCode

    MsspPartADiagnosisCode.ThirdDiagnosisCode

    CMS ACO Part A Procedure Files Load
    ThirdDiagnosisCode

    MsspPartADiagnosisCode.ThirdDiagnosisCode

    CMS ACO Part B DME File Load
    ThirdDiagnosisCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ThirdDiagnosisCode
    MsspPartBPhysicians.CLM_DGNS_3_CD
    CMS CJR DME Claim Procedure Load
    ThirdDiagnosisCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    ThirdDiagnosisCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    ThirdDiagnosisCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    ThirdDiagnosisCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    ThirdDiagnosisCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    ThirdDiagnosisCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    ThirdDiagnosisCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    ThirdDiagnosisCode

    *Not Applicable

    Data Aggregation Service Line Load
    ThirdDiagnosisCode
    AP_PROC_ASSOC_DX.DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Externally Adjudicated ICD Procedure Load
    ThirdDiagnosisCode

    *Not Applicable

    Externally Adjudicated Service Line Load
    ThirdDiagnosisCode
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 3

    Payer System ICD Procedure Load
    ThirdDiagnosisCode

    *Not Applicable

    Payer System Service Line Load
    ThirdDiagnosisCode
    AP_PROC_ASSOC_DX.DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Received Claim ICD Procedure Load
    ThirdDiagnosisCode

    *Not Applicable

    Received Claim Procedure Load
    ThirdDiagnosisCode
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 3

    FourthDiagnosisType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FourthDiagnosisType

    If MsspPartADiagnosisCode.FourthDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FourthDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type"

    CMS ACO Part A Procedure Files Load
    FourthDiagnosisType

    If MsspPartADiagnosisCode.FourthDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FourthDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type"

    CMS ACO Part B DME File Load
    FourthDiagnosisType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FourthDiagnosisType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type"

    CMS CJR DME Claim Procedure Load
    FourthDiagnosisType

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    FourthDiagnosisType

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    FourthDiagnosisType

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    FourthDiagnosisType

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    FourthDiagnosisType

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    FourthDiagnosisType

    *Not Applicable

    CMS CJR Surgical Procedure Load
    FourthDiagnosisType

    *Not Applicable

    Data Aggregation ICD Procedure Load
    FourthDiagnosisType

    *Not Applicable

    Data Aggregation Service Line Load
    FourthDiagnosisType
    AP_PROC_ASSOC_DX.DX_RANK
    ZC_EDG_CODE_SET.NAME
    Externally Adjudicated ICD Procedure Load
    FourthDiagnosisType

    *Not Applicable

    Externally Adjudicated Service Line Load
    FourthDiagnosisType
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 4 then NAME

    Payer System ICD Procedure Load
    FourthDiagnosisType

    *Not Applicable

    Payer System Service Line Load
    FourthDiagnosisType
    AP_PROC_ASSOC_DX.DX_RANK
    ZC_EDG_CODE_SET.NAME
    Received Claim ICD Procedure Load
    FourthDiagnosisType

    *Not Applicable

    Received Claim Procedure Load
    FourthDiagnosisType
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 4 then NAME

    FourthDiagnosisCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FourthDiagnosisCode

    MsspPartADiagnosisCode.FourthDiagnosisCode

    CMS ACO Part A Procedure Files Load
    FourthDiagnosisCode

    MsspPartADiagnosisCode.FourthDiagnosisCode

    CMS ACO Part B DME File Load
    FourthDiagnosisCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FourthDiagnosisCode
    MsspPartBPhysicians.CLM_DGNS_4_CD
    CMS CJR DME Claim Procedure Load
    FourthDiagnosisCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    FourthDiagnosisCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    FourthDiagnosisCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    FourthDiagnosisCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    FourthDiagnosisCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    FourthDiagnosisCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    FourthDiagnosisCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    FourthDiagnosisCode

    *Not Applicable

    Data Aggregation Service Line Load
    FourthDiagnosisCode
    AP_PROC_ASSOC_DX.DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Externally Adjudicated ICD Procedure Load
    FourthDiagnosisCode

    *Not Applicable

    Externally Adjudicated Service Line Load
    FourthDiagnosisCode
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 4

    Payer System ICD Procedure Load
    FourthDiagnosisCode

    *Not Applicable

    Payer System Service Line Load
    FourthDiagnosisCode
    AP_PROC_ASSOC_DX.DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Received Claim ICD Procedure Load
    FourthDiagnosisCode

    *Not Applicable

    Received Claim Procedure Load
    FourthDiagnosisCode
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 4

    FifthDiagnosisType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FifthDiagnosisType

    If MsspPartADiagnosisCode.FifthDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FifthDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type"

    CMS ACO Part A Procedure Files Load
    FifthDiagnosisType

    If MsspPartADiagnosisCode.FifthDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FifthDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type"

    CMS ACO Part B DME File Load
    FifthDiagnosisType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FifthDiagnosisType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type"

    CMS CJR DME Claim Procedure Load
    FifthDiagnosisType

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    FifthDiagnosisType

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    FifthDiagnosisType

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    FifthDiagnosisType

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    FifthDiagnosisType

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    FifthDiagnosisType

    *Not Applicable

    CMS CJR Surgical Procedure Load
    FifthDiagnosisType

    *Not Applicable

    Data Aggregation ICD Procedure Load
    FifthDiagnosisType

    *Not Applicable

    Data Aggregation Service Line Load
    FifthDiagnosisType
    AP_PROC_ASSOC_DX.DX_RANK
    ZC_EDG_CODE_SET.NAME
    Externally Adjudicated ICD Procedure Load
    FifthDiagnosisType

    *Not Applicable

    Externally Adjudicated Service Line Load
    FifthDiagnosisType
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 5 then NAME

    Payer System ICD Procedure Load
    FifthDiagnosisType

    *Not Applicable

    Payer System Service Line Load
    FifthDiagnosisType
    AP_PROC_ASSOC_DX.DX_RANK
    ZC_EDG_CODE_SET.NAME
    Received Claim ICD Procedure Load
    FifthDiagnosisType

    *Not Applicable

    Received Claim Procedure Load
    FifthDiagnosisType
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 5 then NAME

    FifthDiagnosisCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    FifthDiagnosisCode

    MsspPartADiagnosisCode.FifthDiagnosisCode

    CMS ACO Part A Procedure Files Load
    FifthDiagnosisCode

    MsspPartADiagnosisCode.FifthDiagnosisCode

    CMS ACO Part B DME File Load
    FifthDiagnosisCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    FifthDiagnosisCode
    MsspPartBPhysicians.CLM_DGNS_5_CD
    CMS CJR DME Claim Procedure Load
    FifthDiagnosisCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    FifthDiagnosisCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    FifthDiagnosisCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    FifthDiagnosisCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    FifthDiagnosisCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    FifthDiagnosisCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    FifthDiagnosisCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    FifthDiagnosisCode

    *Not Applicable

    Data Aggregation Service Line Load
    FifthDiagnosisCode
    AP_PROC_ASSOC_DX.DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Externally Adjudicated ICD Procedure Load
    FifthDiagnosisCode

    *Not Applicable

    Externally Adjudicated Service Line Load
    FifthDiagnosisCode
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 5

    Payer System ICD Procedure Load
    FifthDiagnosisCode

    *Not Applicable

    Payer System Service Line Load
    FifthDiagnosisCode
    AP_PROC_ASSOC_DX.DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Received Claim ICD Procedure Load
    FifthDiagnosisCode

    *Not Applicable

    Received Claim Procedure Load
    FifthDiagnosisCode
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 5

    SixthDiagnosisType

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SixthDiagnosisType

    If MsspPartADiagnosisCode.SixthDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If SixthDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type"

    CMS ACO Part A Procedure Files Load
    SixthDiagnosisType

    If MsspPartADiagnosisCode.SixthDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If SixthDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type"

    CMS ACO Part B DME File Load
    SixthDiagnosisType

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    SixthDiagnosisType
    MsspPartBPhysicians.DGNS_PRCDR_ICD_IND
    MsspPartBPhysicians.FileGenerationDate

    If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type"

    CMS CJR DME Claim Procedure Load
    SixthDiagnosisType

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    SixthDiagnosisType

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    SixthDiagnosisType

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    SixthDiagnosisType

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    SixthDiagnosisType

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    SixthDiagnosisType

    *Not Applicable

    CMS CJR Surgical Procedure Load
    SixthDiagnosisType

    *Not Applicable

    Data Aggregation ICD Procedure Load
    SixthDiagnosisType

    *Not Applicable

    Data Aggregation Service Line Load
    SixthDiagnosisType
    AP_PROC_ASSOC_DX.DX_RANK
    ZC_EDG_CODE_SET.NAME
    Externally Adjudicated ICD Procedure Load
    SixthDiagnosisType

    *Not Applicable

    Externally Adjudicated Service Line Load
    SixthDiagnosisType
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 4 then NAME

    Payer System ICD Procedure Load
    SixthDiagnosisType

    *Not Applicable

    Payer System Service Line Load
    SixthDiagnosisType
    AP_PROC_ASSOC_DX.DX_RANK
    ZC_EDG_CODE_SET.NAME
    Received Claim ICD Procedure Load
    SixthDiagnosisType

    *Not Applicable

    Received Claim Procedure Load
    SixthDiagnosisType
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE_SET_C
    ZC_EDG_CODE_SET.NAME

    If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 4 then NAME

    SixthDiagnosisCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    SixthDiagnosisCode

    MsspPartADiagnosisCode.SixthDiagnosisCode

    CMS ACO Part A Procedure Files Load
    SixthDiagnosisCode

    MsspPartADiagnosisCode.SixthDiagnosisCode

    CMS ACO Part B DME File Load
    SixthDiagnosisCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    SixthDiagnosisCode
    MsspPartBPhysicians.CLM_DGNS_6_CD
    CMS CJR DME Claim Procedure Load
    SixthDiagnosisCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    SixthDiagnosisCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    SixthDiagnosisCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    SixthDiagnosisCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    SixthDiagnosisCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    SixthDiagnosisCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    SixthDiagnosisCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    SixthDiagnosisCode

    *Not Applicable

    Data Aggregation Service Line Load
    SixthDiagnosisCode
    AP_PROC_ASSOC_DX.DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Externally Adjudicated ICD Procedure Load
    SixthDiagnosisCode

    *Not Applicable

    Externally Adjudicated Service Line Load
    SixthDiagnosisCode
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 6

    Payer System ICD Procedure Load
    SixthDiagnosisCode

    *Not Applicable

    Payer System Service Line Load
    SixthDiagnosisCode
    AP_PROC_ASSOC_DX.DX_RANK
    CLARITY_EDG.REF_BILL_CODE
    Received Claim ICD Procedure Load
    SixthDiagnosisCode

    *Not Applicable

    Received Claim Procedure Load
    SixthDiagnosisCode
    AP_PROC_ASSOC_DX.DX_ID
    AP_PROC_ASSOC_DX.LINE
    CLARITY_EDG.REF_BILL_CODE

    REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 6

    BillingProviderSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    BillingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    BillingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    BillingProviderSpecialty

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    BillingProviderSpecialty

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    BillingProviderSpecialty

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    BillingProviderSpecialty

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    BillingProviderSpecialty

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    BillingProviderSpecialty

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    BillingProviderSpecialty

    *Not Applicable

    CMS CJR Surgical Procedure Load
    BillingProviderSpecialty

    *Not Applicable

    Data Aggregation Service Line Load
    BillingProviderSpecialty
    CLM_VALUES_5.BIL_PROV_SPECIALTY
    Externally Adjudicated ICD Procedure Load
    BillingProviderSpecialty

    *Not Applicable

    Externally Adjudicated Service Line Load
    BillingProviderSpecialty

    "*Unspecified"

    Payer System Service Line Load
    BillingProviderSpecialty
    CLM_VALUES_5.BIL_PROV_SPECIALTY
    Received Claim ICD Procedure Load
    BillingProviderSpecialty
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES.RECORD_ID
    Received Claim Procedure Load
    BillingProviderSpecialty
    AP_CLAIM.ORIG_ADJST_CLM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_3.MOST_RECENT_INCOMING_CEV_ID
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES.RECORD_ID

    ReferringProviderSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReferringProviderSpecialty

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    ReferringProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    ReferringProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ReferringProviderSpecialty

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    ReferringProviderSpecialty

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    ReferringProviderSpecialty

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    ReferringProviderSpecialty

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    ReferringProviderSpecialty

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    ReferringProviderSpecialty

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    ReferringProviderSpecialty

    *Not Applicable

    CMS CJR Surgical Procedure Load
    ReferringProviderSpecialty

    *Not Applicable

    Externally Adjudicated ICD Procedure Load
    ReferringProviderSpecialty

    *Not Applicable

    Externally Adjudicated Service Line Load
    ReferringProviderSpecialty

    "*Unspecified"

    Received Claim ICD Procedure Load
    ReferringProviderSpecialty
    CLARITY_SER_SPEC.SPECIALTY_C
    CLM_VALUES_2.REF_PROV_TAXONOMY
    ZC_SPECIALTY.NAME
    ZC_SPECIALTY.SPECIALTY_C

    If REF_PROV_TAXONOMY is not NULL then REF_PROV_TAXONOMY Otherwise if CLARITY_SER_SPEC.SPECIALTY_C is NULL then *Unspecified Otherwise if ZC_SPECIALTY.SPECIALTY_C is NULL then *Unknown Otherwise NAME

    Received Claim Procedure Load
    ReferringProviderSpecialty
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLARITY_SER_SPEC.SPECIALTY_C
    CLM_VALUES_2.REF_PROV_NPI
    CLM_VALUES_2.REF_PROV_TAXONOMY
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_REF_NPI
    ZC_SPECIALTY.NAME
    ZC_SPECIALTY.SPECIALTY_C

    If LN_REF_NPI = REF_PROV_NPI and the number of services has not been modified in the system then REF_PROV_TAXONOMY Otherwise if LN_REF_NPI is NULL and the number of services has not been modified in the system then REF_PROV_TAXONOMY Otherwise if CLARITY_SER_SPEC.SPECIALTY_C is NULL then "*Unspecified" Otherwise if ZC_SPECIALTY.SPECIALTY_C is NULL then "*Unknown" Otherwise NAME

    RenderingProviderSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RenderingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    RenderingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    RenderingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    RenderingProviderSpecialty
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartBPhysicians.CLM_PRVDR_SPCLTY_CD

    If CLM_PRVDR_SPCLTY_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ProviderSpecialtyCode" then "*Unknown" Otherwise Name where CategoryName = "ProviderSpecialtyCode"

    CMS CJR DME Claim Procedure Load
    RenderingProviderSpecialty
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrDmeDetail.HCFASPCL

    If HCFASPCL is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ProviderSpecialtyCode then *Unknown Otherwise Name where CategoryName = ProviderSpecialtyCode

    CMS CJR Home Health Claim Procedure Load
    RenderingProviderSpecialty

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    RenderingProviderSpecialty

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    RenderingProviderSpecialty

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    RenderingProviderSpecialty
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrPartBDetail.HCFASPCL

    If HCFASPCL is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ProviderSpecialtyCode then *Unknown Otherwise Name where CategoryName = ProviderSpecialtyCode

    CMS CJR Skilled Nursing Claim Procedure Load
    RenderingProviderSpecialty

    *Not Applicable

    CMS CJR Surgical Procedure Load
    RenderingProviderSpecialty

    *Not Applicable

    Externally Adjudicated ICD Procedure Load
    RenderingProviderSpecialty

    *Not Applicable

    Externally Adjudicated Service Line Load
    RenderingProviderSpecialty

    "*Unspecified"

    Received Claim ICD Procedure Load
    RenderingProviderSpecialty
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_2.REND_PROV_TAXONOMY
    CLM_VALUES_3.ASST_SURG_NPI
    CLM_VALUES_3.ASST_SURG_TAXONOMY

    If REND_PROV_NPI is not NULL then REND_PROV_TAXONOMY Otherwise if RENDERING_PROV_ID is not NULL then NULL Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_TAXONOMY Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_TAXONOMY

    Received Claim Procedure Load
    RenderingProviderSpecialty
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_2.REND_PROV_TAXONOMY
    CLM_VALUES_3.ASST_SURG_NPI
    CLM_VALUES_3.ASST_SURG_TAXONOMY
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI
    SVC_LN_INFO.LN_REND_TAXONOMY

    If the number of services has been modified in the system then NULL Otherwise if LN_REND_NPI is not NULL then LN_REND_TAXONOMY Otherwise if REND_PROV_NPI is not NULL then REND_PROV_TAXONOMY Otherwise if RENDERING_PROV_ID is not NULL then NULL Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_TAXONOMY Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_TAXONOMY

    AttendingProviderSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    AttendingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    AttendingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AttendingProviderSpecialty

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    AttendingProviderSpecialty

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    AttendingProviderSpecialty

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    AttendingProviderSpecialty

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    AttendingProviderSpecialty

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    AttendingProviderSpecialty

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    AttendingProviderSpecialty

    *Not Applicable

    CMS CJR Surgical Procedure Load
    AttendingProviderSpecialty

    *Not Applicable

    Externally Adjudicated ICD Procedure Load
    AttendingProviderSpecialty

    *Not Applicable

    Externally Adjudicated Service Line Load
    AttendingProviderSpecialty

    "*Unspecified"

    Received Claim ICD Procedure Load
    AttendingProviderSpecialty
    CLM_VALUES_2.ATT_PROV_TAXONOMY
    Received Claim Procedure Load
    AttendingProviderSpecialty
    CLM_VALUES_2.ATT_PROV_TAXONOMY

    OperatingProviderSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    OperatingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OperatingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OperatingProviderSpecialty

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    OperatingProviderSpecialty

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    OperatingProviderSpecialty

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    OperatingProviderSpecialty

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    OperatingProviderSpecialty

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    OperatingProviderSpecialty

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OperatingProviderSpecialty

    *Not Applicable

    CMS CJR Surgical Procedure Load
    OperatingProviderSpecialty

    *Not Applicable

    Data Aggregation ICD Procedure Load
    OperatingProviderSpecialty

    *Not Applicable

    Data Aggregation Service Line Load
    OperatingProviderSpecialty

    "*Unspecified"

    Externally Adjudicated ICD Procedure Load
    OperatingProviderSpecialty

    *Not Applicable

    Externally Adjudicated Service Line Load
    OperatingProviderSpecialty

    "*Unspecified"

    Payer System ICD Procedure Load
    OperatingProviderSpecialty

    *Not Applicable

    Payer System Service Line Load
    OperatingProviderSpecialty

    "*Unspecified"

    Received Claim ICD Procedure Load
    OperatingProviderSpecialty

    *Not Applicable

    Received Claim Procedure Load
    OperatingProviderSpecialty

    "*Unspecified"

    OtherProviderSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderSpecialty

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    OtherProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OtherProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OtherProviderSpecialty

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    OtherProviderSpecialty

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    OtherProviderSpecialty

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    OtherProviderSpecialty

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    OtherProviderSpecialty

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    OtherProviderSpecialty

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OtherProviderSpecialty

    *Not Applicable

    CMS CJR Surgical Procedure Load
    OtherProviderSpecialty

    *Not Applicable

    Data Aggregation ICD Procedure Load
    OtherProviderSpecialty

    *Not Applicable

    Data Aggregation Service Line Load
    OtherProviderSpecialty

    "*Unspecified"

    Externally Adjudicated ICD Procedure Load
    OtherProviderSpecialty

    *Not Applicable

    Externally Adjudicated Service Line Load
    OtherProviderSpecialty

    "*Unspecified"

    Payer System ICD Procedure Load
    OtherProviderSpecialty

    *Not Applicable

    Payer System Service Line Load
    OtherProviderSpecialty

    "*Unspecified"

    Received Claim ICD Procedure Load
    OtherProviderSpecialty

    *Not Applicable

    Received Claim Procedure Load
    OtherProviderSpecialty

    "*Unspecified"

    OrderingProviderSpecialty

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OrderingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    OrderingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OrderingProviderSpecialty

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OrderingProviderSpecialty

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    OrderingProviderSpecialty

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    OrderingProviderSpecialty

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    OrderingProviderSpecialty

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    OrderingProviderSpecialty

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    OrderingProviderSpecialty

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OrderingProviderSpecialty

    *Not Applicable

    CMS CJR Surgical Procedure Load
    OrderingProviderSpecialty

    *Not Applicable

    Data Aggregation ICD Procedure Load
    OrderingProviderSpecialty

    *Not Applicable

    Data Aggregation Service Line Load
    OrderingProviderSpecialty

    "*Unspecified"

    Externally Adjudicated ICD Procedure Load
    OrderingProviderSpecialty

    *Not Applicable

    Externally Adjudicated Service Line Load
    OrderingProviderSpecialty

    "*Unspecified"

    Payer System ICD Procedure Load
    OrderingProviderSpecialty

    *Not Applicable

    Payer System Service Line Load
    OrderingProviderSpecialty

    "*Unspecified"

    Received Claim ICD Procedure Load
    OrderingProviderSpecialty

    *Not Applicable

    Received Claim Procedure Load
    OrderingProviderSpecialty

    "*Unspecified"

    BillingProviderCmsSpecialtyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    BillingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    BillingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    BillingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    BillingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    BillingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    BillingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    BillingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    BillingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    BillingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    BillingProviderCmsSpecialtyCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    BillingProviderCmsSpecialtyCode

    NULL

    Data Aggregation Service Line Load
    BillingProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated ICD Procedure Load
    BillingProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated Service Line Load
    BillingProviderCmsSpecialtyCode

    NULL

    Payer System ICD Procedure Load
    BillingProviderCmsSpecialtyCode

    NULL

    Payer System Service Line Load
    BillingProviderCmsSpecialtyCode

    NULL

    Received Claim ICD Procedure Load
    BillingProviderCmsSpecialtyCode

    NULL

    Received Claim Procedure Load
    BillingProviderCmsSpecialtyCode

    NULL

    BillingProviderCmsSpecialtyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    BillingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    BillingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    BillingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    BillingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    BillingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    BillingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    BillingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    BillingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    BillingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Surgical Procedure Load
    BillingProviderCmsSpecialtyName

    *Not Applicable

    Data Aggregation ICD Procedure Load
    BillingProviderCmsSpecialtyName

    NULL

    Data Aggregation Service Line Load
    BillingProviderCmsSpecialtyName

    NULL

    Externally Adjudicated ICD Procedure Load
    BillingProviderCmsSpecialtyName

    NULL

    Externally Adjudicated Service Line Load
    BillingProviderCmsSpecialtyName

    NULL

    Payer System ICD Procedure Load
    BillingProviderCmsSpecialtyName

    NULL

    Payer System Service Line Load
    BillingProviderCmsSpecialtyName

    NULL

    Received Claim ICD Procedure Load
    BillingProviderCmsSpecialtyName

    NULL

    Received Claim Procedure Load
    BillingProviderCmsSpecialtyName

    NULL

    ReferringProviderCmsSpecialtyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReferringProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    ReferringProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    ReferringProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ReferringProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    ReferringProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    ReferringProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    ReferringProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    ReferringProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    ReferringProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    ReferringProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    ReferringProviderCmsSpecialtyCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    ReferringProviderCmsSpecialtyCode

    NULL

    Data Aggregation Service Line Load
    ReferringProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated ICD Procedure Load
    ReferringProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated Service Line Load
    ReferringProviderCmsSpecialtyCode

    NULL

    Payer System ICD Procedure Load
    ReferringProviderCmsSpecialtyCode

    NULL

    Payer System Service Line Load
    ReferringProviderCmsSpecialtyCode

    NULL

    Received Claim ICD Procedure Load
    ReferringProviderCmsSpecialtyCode

    NULL

    Received Claim Procedure Load
    ReferringProviderCmsSpecialtyCode

    NULL

    ReferringProviderCmsSpecialtyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReferringProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    ReferringProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    ReferringProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ReferringProviderCmsSpecialtyName

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    ReferringProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    ReferringProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    ReferringProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    ReferringProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    ReferringProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    ReferringProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Surgical Procedure Load
    ReferringProviderCmsSpecialtyName

    *Not Applicable

    Data Aggregation ICD Procedure Load
    ReferringProviderCmsSpecialtyName

    NULL

    Data Aggregation Service Line Load
    ReferringProviderCmsSpecialtyName

    NULL

    Externally Adjudicated ICD Procedure Load
    ReferringProviderCmsSpecialtyName

    NULL

    Externally Adjudicated Service Line Load
    ReferringProviderCmsSpecialtyName

    NULL

    Payer System ICD Procedure Load
    ReferringProviderCmsSpecialtyName

    NULL

    Payer System Service Line Load
    ReferringProviderCmsSpecialtyName

    NULL

    Received Claim ICD Procedure Load
    ReferringProviderCmsSpecialtyName

    NULL

    Received Claim Procedure Load
    ReferringProviderCmsSpecialtyName

    NULL

    RenderingProviderCmsSpecialtyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RenderingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    RenderingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    RenderingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    RenderingProviderCmsSpecialtyCode
    MsspPartBPhysicians.CLM_PRVDR_SPCLTY_CD
    CMS CJR DME Claim Procedure Load
    RenderingProviderCmsSpecialtyCode
    CmsCjrDmeDetail.HCFASPCL
    CMS CJR Home Health Claim Procedure Load
    RenderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    RenderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    RenderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    RenderingProviderCmsSpecialtyCode
    CmsCjrPartBDetail.HCFASPCL
    CMS CJR Skilled Nursing Claim Procedure Load
    RenderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    RenderingProviderCmsSpecialtyCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    RenderingProviderCmsSpecialtyCode

    NULL

    Data Aggregation Service Line Load
    RenderingProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated ICD Procedure Load
    RenderingProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated Service Line Load
    RenderingProviderCmsSpecialtyCode

    NULL

    Payer System ICD Procedure Load
    RenderingProviderCmsSpecialtyCode

    NULL

    Payer System Service Line Load
    RenderingProviderCmsSpecialtyCode

    NULL

    Received Claim ICD Procedure Load
    RenderingProviderCmsSpecialtyCode

    NULL

    Received Claim Procedure Load
    RenderingProviderCmsSpecialtyCode

    NULL

    RenderingProviderCmsSpecialtyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RenderingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    RenderingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    RenderingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    RenderingProviderCmsSpecialtyName
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    MsspPartBPhysicians.CLM_PRVDR_SPCLTY_CD

    If CLM_PRVDR_SPCLTY_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ProviderSpecialtyCode" then "*Unknown " Otherwise Name where CategoryName = "ProviderSpecialtyCode"

    CMS CJR DME Claim Procedure Load
    RenderingProviderCmsSpecialtyName
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrDmeDetail.HCFASPCL

    If HCFASPCL is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ProviderSpecialtyCode then *Unknown Otherwise Name where CategoryName = ProviderSpecialtyCode

    CMS CJR Home Health Claim Procedure Load
    RenderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    RenderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    RenderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    RenderingProviderCmsSpecialtyName
    CmsCategoryList.CategoryName
    CmsCategoryList.Id
    CmsCategoryList.Name
    CmsCjrPartBDetail.HCFASPCL

    If HCFASPCL is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ProviderSpecialtyCode then *Unknown Otherwise Name where CategoryName = ProviderSpecialtyCode

    CMS CJR Skilled Nursing Claim Procedure Load
    RenderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Surgical Procedure Load
    RenderingProviderCmsSpecialtyName

    *Not Applicable

    Data Aggregation ICD Procedure Load
    RenderingProviderCmsSpecialtyName

    NULL

    Data Aggregation Service Line Load
    RenderingProviderCmsSpecialtyName

    NULL

    Externally Adjudicated ICD Procedure Load
    RenderingProviderCmsSpecialtyName

    NULL

    Externally Adjudicated Service Line Load
    RenderingProviderCmsSpecialtyName

    NULL

    Payer System ICD Procedure Load
    RenderingProviderCmsSpecialtyName

    NULL

    Payer System Service Line Load
    RenderingProviderCmsSpecialtyName

    NULL

    Received Claim ICD Procedure Load
    RenderingProviderCmsSpecialtyName

    NULL

    Received Claim Procedure Load
    RenderingProviderCmsSpecialtyName

    NULL

    AttendingProviderCmsSpecialtyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    AttendingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    AttendingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AttendingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    AttendingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    AttendingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    AttendingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    AttendingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    AttendingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    AttendingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    AttendingProviderCmsSpecialtyCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    AttendingProviderCmsSpecialtyCode

    NULL

    Data Aggregation Service Line Load
    AttendingProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated ICD Procedure Load
    AttendingProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated Service Line Load
    AttendingProviderCmsSpecialtyCode

    NULL

    Payer System ICD Procedure Load
    AttendingProviderCmsSpecialtyCode

    NULL

    Payer System Service Line Load
    AttendingProviderCmsSpecialtyCode

    NULL

    Received Claim ICD Procedure Load
    AttendingProviderCmsSpecialtyCode

    NULL

    Received Claim Procedure Load
    AttendingProviderCmsSpecialtyCode

    NULL

    AttendingProviderCmsSpecialtyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    AttendingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    AttendingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AttendingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    AttendingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    AttendingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    AttendingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    AttendingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    AttendingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    AttendingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Surgical Procedure Load
    AttendingProviderCmsSpecialtyName

    *Not Applicable

    Data Aggregation ICD Procedure Load
    AttendingProviderCmsSpecialtyName

    NULL

    Data Aggregation Service Line Load
    AttendingProviderCmsSpecialtyName

    NULL

    Externally Adjudicated ICD Procedure Load
    AttendingProviderCmsSpecialtyName

    NULL

    Externally Adjudicated Service Line Load
    AttendingProviderCmsSpecialtyName

    NULL

    Payer System ICD Procedure Load
    AttendingProviderCmsSpecialtyName

    NULL

    Payer System Service Line Load
    AttendingProviderCmsSpecialtyName

    NULL

    Received Claim ICD Procedure Load
    AttendingProviderCmsSpecialtyName

    NULL

    Received Claim Procedure Load
    AttendingProviderCmsSpecialtyName

    NULL

    OperatingProviderCmsSpecialtyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    OperatingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OperatingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OperatingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    OperatingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    OperatingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    OperatingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    OperatingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    OperatingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OperatingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    OperatingProviderCmsSpecialtyCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    OperatingProviderCmsSpecialtyCode

    NULL

    Data Aggregation Service Line Load
    OperatingProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated ICD Procedure Load
    OperatingProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated Service Line Load
    OperatingProviderCmsSpecialtyCode

    NULL

    Payer System ICD Procedure Load
    OperatingProviderCmsSpecialtyCode

    NULL

    Payer System Service Line Load
    OperatingProviderCmsSpecialtyCode

    NULL

    Received Claim ICD Procedure Load
    OperatingProviderCmsSpecialtyCode

    NULL

    Received Claim Procedure Load
    OperatingProviderCmsSpecialtyCode

    NULL

    OperatingProviderCmsSpecialtyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    OperatingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OperatingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OperatingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    OperatingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    OperatingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    OperatingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    OperatingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    OperatingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OperatingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Surgical Procedure Load
    OperatingProviderCmsSpecialtyName

    *Not Applicable

    Data Aggregation ICD Procedure Load
    OperatingProviderCmsSpecialtyName

    NULL

    Data Aggregation Service Line Load
    OperatingProviderCmsSpecialtyName

    NULL

    Externally Adjudicated ICD Procedure Load
    OperatingProviderCmsSpecialtyName

    NULL

    Externally Adjudicated Service Line Load
    OperatingProviderCmsSpecialtyName

    NULL

    Payer System ICD Procedure Load
    OperatingProviderCmsSpecialtyName

    NULL

    Payer System Service Line Load
    OperatingProviderCmsSpecialtyName

    NULL

    Received Claim ICD Procedure Load
    OperatingProviderCmsSpecialtyName

    NULL

    Received Claim Procedure Load
    OperatingProviderCmsSpecialtyName

    NULL

    OtherProviderCmsSpecialtyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    OtherProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OtherProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OtherProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    OtherProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    OtherProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    OtherProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    OtherProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    OtherProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OtherProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    OtherProviderCmsSpecialtyCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    OtherProviderCmsSpecialtyCode

    NULL

    Data Aggregation Service Line Load
    OtherProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated ICD Procedure Load
    OtherProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated Service Line Load
    OtherProviderCmsSpecialtyCode

    NULL

    Payer System ICD Procedure Load
    OtherProviderCmsSpecialtyCode

    NULL

    Payer System Service Line Load
    OtherProviderCmsSpecialtyCode

    NULL

    Received Claim ICD Procedure Load
    OtherProviderCmsSpecialtyCode

    NULL

    Received Claim Procedure Load
    OtherProviderCmsSpecialtyCode

    NULL

    OtherProviderCmsSpecialtyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    OtherProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OtherProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OtherProviderCmsSpecialtyName

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    OtherProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    OtherProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    OtherProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    OtherProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    OtherProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OtherProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Surgical Procedure Load
    OtherProviderCmsSpecialtyName

    *Not Applicable

    Data Aggregation ICD Procedure Load
    OtherProviderCmsSpecialtyName

    NULL

    Data Aggregation Service Line Load
    OtherProviderCmsSpecialtyName

    NULL

    Externally Adjudicated ICD Procedure Load
    OtherProviderCmsSpecialtyName

    NULL

    Externally Adjudicated Service Line Load
    OtherProviderCmsSpecialtyName

    NULL

    Payer System ICD Procedure Load
    OtherProviderCmsSpecialtyName

    NULL

    Payer System Service Line Load
    OtherProviderCmsSpecialtyName

    NULL

    Received Claim ICD Procedure Load
    OtherProviderCmsSpecialtyName

    NULL

    Received Claim Procedure Load
    OtherProviderCmsSpecialtyName

    NULL

    OrderingProviderCmsSpecialtyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OrderingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    OrderingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OrderingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OrderingProviderCmsSpecialtyCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    OrderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    OrderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    OrderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    OrderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    OrderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OrderingProviderCmsSpecialtyCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    OrderingProviderCmsSpecialtyCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    OrderingProviderCmsSpecialtyCode

    NULL

    Data Aggregation Service Line Load
    OrderingProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated ICD Procedure Load
    OrderingProviderCmsSpecialtyCode

    NULL

    Externally Adjudicated Service Line Load
    OrderingProviderCmsSpecialtyCode

    NULL

    Payer System ICD Procedure Load
    OrderingProviderCmsSpecialtyCode

    NULL

    Payer System Service Line Load
    OrderingProviderCmsSpecialtyCode

    NULL

    Received Claim ICD Procedure Load
    OrderingProviderCmsSpecialtyCode

    NULL

    Received Claim Procedure Load
    OrderingProviderCmsSpecialtyCode

    NULL

    OrderingProviderCmsSpecialtyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OrderingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    OrderingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OrderingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OrderingProviderCmsSpecialtyName

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    OrderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    OrderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    OrderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    OrderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    OrderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OrderingProviderCmsSpecialtyName

    *Not Applicable

    CMS CJR Surgical Procedure Load
    OrderingProviderCmsSpecialtyName

    *Not Applicable

    Data Aggregation ICD Procedure Load
    OrderingProviderCmsSpecialtyName

    NULL

    Data Aggregation Service Line Load
    OrderingProviderCmsSpecialtyName

    NULL

    Externally Adjudicated ICD Procedure Load
    OrderingProviderCmsSpecialtyName

    NULL

    Externally Adjudicated Service Line Load
    OrderingProviderCmsSpecialtyName

    NULL

    Payer System ICD Procedure Load
    OrderingProviderCmsSpecialtyName

    NULL

    Payer System Service Line Load
    OrderingProviderCmsSpecialtyName

    NULL

    Received Claim ICD Procedure Load
    OrderingProviderCmsSpecialtyName

    NULL

    Received Claim Procedure Load
    OrderingProviderCmsSpecialtyName

    NULL

    BillingProviderTaxonomyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    BillingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    BillingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    BillingProviderTaxonomyCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    BillingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    BillingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    BillingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    BillingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    BillingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    BillingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    BillingProviderTaxonomyCode

    *Not Applicable

    Data Aggregation Service Line Load
    BillingProviderTaxonomyCode
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES.RECORD_ID
    Externally Adjudicated ICD Procedure Load
    BillingProviderTaxonomyCode

    NULL

    Externally Adjudicated Service Line Load
    BillingProviderTaxonomyCode

    NULL

    Payer System Service Line Load
    BillingProviderTaxonomyCode
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES.RECORD_ID
    Received Claim ICD Procedure Load
    BillingProviderTaxonomyCode
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES.RECORD_ID
    Received Claim Procedure Load
    BillingProviderTaxonomyCode
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES.RECORD_ID

    BillingProviderTaxonomyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BillingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    BillingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    BillingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    BillingProviderTaxonomyName

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    BillingProviderTaxonomyName

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    BillingProviderTaxonomyName

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    BillingProviderTaxonomyName

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    BillingProviderTaxonomyName

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    BillingProviderTaxonomyName

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    BillingProviderTaxonomyName

    *Not Applicable

    CMS CJR Surgical Procedure Load
    BillingProviderTaxonomyName

    *Not Applicable

    Data Aggregation ICD Procedure Load
    BillingProviderTaxonomyName

    NULL

    Data Aggregation Service Line Load
    BillingProviderTaxonomyName

    NULL

    Externally Adjudicated ICD Procedure Load
    BillingProviderTaxonomyName

    NULL

    Externally Adjudicated Service Line Load
    BillingProviderTaxonomyName

    NULL

    Payer System ICD Procedure Load
    BillingProviderTaxonomyName

    NULL

    Payer System Service Line Load
    BillingProviderTaxonomyName

    NULL

    Received Claim ICD Procedure Load
    BillingProviderTaxonomyName

    NULL

    Received Claim Procedure Load
    BillingProviderTaxonomyName

    NULL

    ReferringProviderTaxonomyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReferringProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    ReferringProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    ReferringProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ReferringProviderTaxonomyCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    ReferringProviderTaxonomyCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    ReferringProviderTaxonomyCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    ReferringProviderTaxonomyCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    ReferringProviderTaxonomyCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    ReferringProviderTaxonomyCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    ReferringProviderTaxonomyCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    ReferringProviderTaxonomyCode

    *Not Applicable

    Data Aggregation Service Line Load
    ReferringProviderTaxonomyCode
    CLM_VALUES_2.REF_PROV_TAXONOMY
    Externally Adjudicated ICD Procedure Load
    ReferringProviderTaxonomyCode

    NULL

    Externally Adjudicated Service Line Load
    ReferringProviderTaxonomyCode

    NULL

    Payer System Service Line Load
    ReferringProviderTaxonomyCode
    CLM_VALUES_2.REF_PROV_TAXONOMY
    Received Claim ICD Procedure Load
    ReferringProviderTaxonomyCode
    CLM_VALUES_2.REF_PROV_TAXONOMY
    Received Claim Procedure Load
    ReferringProviderTaxonomyCode
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES_2.REF_PROV_NPI
    CLM_VALUES_2.REF_PROV_TAXONOMY
    SVC_LN_INFO.LINE
    SVC_LN_INFO_2.LN_REF_NPI

    If LN_REF_NPI = REF_PROV_NPI and the number of services has not been modified in the system then REF_PROV_TAXONOMY Otherwise if LN_REF_NPI is NULL and the number of services has not been modified in the system then REF_PROV_TAXONOMY Otherwise "*Unspecified"

    ReferringProviderTaxonomyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ReferringProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    ReferringProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    ReferringProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    ReferringProviderTaxonomyName

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    ReferringProviderTaxonomyName

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    ReferringProviderTaxonomyName

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    ReferringProviderTaxonomyName

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    ReferringProviderTaxonomyName

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    ReferringProviderTaxonomyName

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    ReferringProviderTaxonomyName

    *Not Applicable

    CMS CJR Surgical Procedure Load
    ReferringProviderTaxonomyName

    *Not Applicable

    Data Aggregation ICD Procedure Load
    ReferringProviderTaxonomyName

    NULL

    Data Aggregation Service Line Load
    ReferringProviderTaxonomyName

    NULL

    Externally Adjudicated ICD Procedure Load
    ReferringProviderTaxonomyName

    NULL

    Externally Adjudicated Service Line Load
    ReferringProviderTaxonomyName

    NULL

    Payer System ICD Procedure Load
    ReferringProviderTaxonomyName

    NULL

    Payer System Service Line Load
    ReferringProviderTaxonomyName

    NULL

    Received Claim ICD Procedure Load
    ReferringProviderTaxonomyName

    NULL

    Received Claim Procedure Load
    ReferringProviderTaxonomyName

    NULL

    RenderingProviderTaxonomyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RenderingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    RenderingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    RenderingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    RenderingProviderTaxonomyCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    RenderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    RenderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    RenderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    RenderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    RenderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    RenderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    RenderingProviderTaxonomyCode

    *Not Applicable

    Data Aggregation Service Line Load
    RenderingProviderTaxonomyCode
    SVC_LN_INFO.LN_REND_TAXONOMY
    Externally Adjudicated ICD Procedure Load
    RenderingProviderTaxonomyCode

    NULL

    Externally Adjudicated Service Line Load
    RenderingProviderTaxonomyCode

    NULL

    Payer System Service Line Load
    RenderingProviderTaxonomyCode
    SVC_LN_INFO.LN_REND_TAXONOMY
    Received Claim ICD Procedure Load
    RenderingProviderTaxonomyCode
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_2.REND_PROV_TAXONOMY
    CLM_VALUES_3.ASST_SURG_NPI
    CLM_VALUES_3.ASST_SURG_TAXONOMY

    If REND_PROV_NPI is not NULL then REND_PROV_TAXONOMY Otherwise if RENDERING_PROV_ID is not NULL then NULL Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_TAXONOMY Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_TAXONOMY

    Received Claim Procedure Load
    RenderingProviderTaxonomyCode
    AP_CLAIM.CLAIM_FORMAT_C
    AP_CLAIM_2.DENTAL_INFO_YN
    AP_CLAIM_2.RENDERING_PROV_ID
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    CLM_VALUES.BIL_PROV_NPI
    CLM_VALUES.BIL_PROV_TAXONOMY
    CLM_VALUES_2.REND_PROV_NPI
    CLM_VALUES_2.REND_PROV_TAXONOMY
    CLM_VALUES_3.ASST_SURG_NPI
    CLM_VALUES_3.ASST_SURG_TAXONOMY
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_REND_NPI
    SVC_LN_INFO.LN_REND_TAXONOMY

    If the number of services has been modified in the system then NULL Otherwise if LN_REND_NPI is not NULL then LN_REND_TAXONOMY Otherwise if REND_PROV_NPI is not NULL then REND_PROV_TAXONOMY Otherwise if RENDERING_PROV_ID is not NULL then NULL Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_TAXONOMY Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_TAXONOMY

    RenderingProviderTaxonomyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    RenderingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    RenderingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    RenderingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    RenderingProviderTaxonomyName

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    RenderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    RenderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    RenderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    RenderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    RenderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    RenderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Surgical Procedure Load
    RenderingProviderTaxonomyName

    *Not Applicable

    Data Aggregation ICD Procedure Load
    RenderingProviderTaxonomyName

    NULL

    Data Aggregation Service Line Load
    RenderingProviderTaxonomyName

    NULL

    Externally Adjudicated ICD Procedure Load
    RenderingProviderTaxonomyName

    NULL

    Externally Adjudicated Service Line Load
    RenderingProviderTaxonomyName

    NULL

    Payer System ICD Procedure Load
    RenderingProviderTaxonomyName

    NULL

    Payer System Service Line Load
    RenderingProviderTaxonomyName

    NULL

    Received Claim ICD Procedure Load
    RenderingProviderTaxonomyName

    NULL

    Received Claim Procedure Load
    RenderingProviderTaxonomyName

    NULL

    AttendingProviderTaxonomyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    AttendingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    AttendingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AttendingProviderTaxonomyCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    AttendingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    AttendingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    AttendingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    AttendingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    AttendingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    AttendingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    AttendingProviderTaxonomyCode

    *Not Applicable

    Data Aggregation Service Line Load
    AttendingProviderTaxonomyCode
    CLM_VALUES_2.ATT_PROV_TAXONOMY
    Externally Adjudicated ICD Procedure Load
    AttendingProviderTaxonomyCode

    NULL

    Externally Adjudicated Service Line Load
    AttendingProviderTaxonomyCode
    CLM_VALUES_2.ATT_PROV_TAXONOMY
    Payer System Service Line Load
    AttendingProviderTaxonomyCode
    CLM_VALUES_2.ATT_PROV_TAXONOMY
    Received Claim ICD Procedure Load
    AttendingProviderTaxonomyCode
    CLM_VALUES_2.ATT_PROV_TAXONOMY
    Received Claim Procedure Load
    AttendingProviderTaxonomyCode
    CLM_VALUES_2.ATT_PROV_TAXONOMY

    AttendingProviderTaxonomyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AttendingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    AttendingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    AttendingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    AttendingProviderTaxonomyName

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    AttendingProviderTaxonomyName

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    AttendingProviderTaxonomyName

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    AttendingProviderTaxonomyName

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    AttendingProviderTaxonomyName

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    AttendingProviderTaxonomyName

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    AttendingProviderTaxonomyName

    *Not Applicable

    CMS CJR Surgical Procedure Load
    AttendingProviderTaxonomyName

    *Not Applicable

    Data Aggregation ICD Procedure Load
    AttendingProviderTaxonomyName

    NULL

    Data Aggregation Service Line Load
    AttendingProviderTaxonomyName

    NULL

    Externally Adjudicated ICD Procedure Load
    AttendingProviderTaxonomyName

    NULL

    Externally Adjudicated Service Line Load
    AttendingProviderTaxonomyName

    NULL

    Payer System ICD Procedure Load
    AttendingProviderTaxonomyName

    NULL

    Payer System Service Line Load
    AttendingProviderTaxonomyName

    NULL

    Received Claim ICD Procedure Load
    AttendingProviderTaxonomyName

    NULL

    Received Claim Procedure Load
    AttendingProviderTaxonomyName

    NULL

    OperatingProviderTaxonomyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    OperatingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OperatingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OperatingProviderTaxonomyCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    Data Aggregation Service Line Load
    OperatingProviderTaxonomyCode
    CLM_VALUES_5.OPER_PROV_TAXONOMY
    SVC_LN_INFO_2.LN_OPR_NPI
    SVC_LN_INFO_3.LN_OPR_TAXONOMY

    If LN_OPER_TAXONOMY is not null then LN_OPER_TAXONOMY Otherwise OPER_PROV_TAXONOMY

    Externally Adjudicated ICD Procedure Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    Externally Adjudicated Service Line Load
    OperatingProviderTaxonomyCode

    "*Unspecified"

    Payer System ICD Procedure Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    Payer System Service Line Load
    OperatingProviderTaxonomyCode
    CLM_VALUES_5.OPER_PROV_TAXONOMY
    SVC_LN_INFO_2.LN_OPR_NPI
    SVC_LN_INFO_3.LN_OPR_TAXONOMY

    If LN_OPER_TAXONOMY is not null then LN_OPER_TAXONOMY Otherwise OPER_PROV_TAXONOMY

    Received Claim ICD Procedure Load
    OperatingProviderTaxonomyCode

    *Not Applicable

    Received Claim Procedure Load
    OperatingProviderTaxonomyCode

    "*Unspecified"

    OperatingProviderTaxonomyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OperatingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    OperatingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OperatingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OperatingProviderTaxonomyName

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    OperatingProviderTaxonomyName

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    OperatingProviderTaxonomyName

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    OperatingProviderTaxonomyName

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    OperatingProviderTaxonomyName

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    OperatingProviderTaxonomyName

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OperatingProviderTaxonomyName

    *Not Applicable

    CMS CJR Surgical Procedure Load
    OperatingProviderTaxonomyName

    *Not Applicable

    Data Aggregation ICD Procedure Load
    OperatingProviderTaxonomyName

    NULL

    Data Aggregation Service Line Load
    OperatingProviderTaxonomyName

    NULL

    Externally Adjudicated ICD Procedure Load
    OperatingProviderTaxonomyName

    NULL

    Externally Adjudicated Service Line Load
    OperatingProviderTaxonomyName

    NULL

    Payer System ICD Procedure Load
    OperatingProviderTaxonomyName

    NULL

    Payer System Service Line Load
    OperatingProviderTaxonomyName

    NULL

    Received Claim ICD Procedure Load
    OperatingProviderTaxonomyName

    NULL

    Received Claim Procedure Load
    OperatingProviderTaxonomyName

    NULL

    OtherProviderTaxonomyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OtherProviderTaxonomyCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    OtherProviderTaxonomyCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    OtherProviderTaxonomyCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    OtherProviderTaxonomyCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    OtherProviderTaxonomyCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    OtherProviderTaxonomyCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OtherProviderTaxonomyCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    OtherProviderTaxonomyCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    OtherProviderTaxonomyCode

    *Not Applicable

    Data Aggregation Service Line Load
    OtherProviderTaxonomyCode

    "*Unspecified"

    Externally Adjudicated ICD Procedure Load
    OtherProviderTaxonomyCode

    *Not Applicable

    Externally Adjudicated Service Line Load
    OtherProviderTaxonomyCode

    "*Unspecified"

    Payer System ICD Procedure Load
    OtherProviderTaxonomyCode

    *Not Applicable

    Payer System Service Line Load
    OtherProviderTaxonomyCode

    "*Unspecified"

    Received Claim ICD Procedure Load
    OtherProviderTaxonomyCode

    *Not Applicable

    Received Claim Procedure Load
    OtherProviderTaxonomyCode

    "*Unspecified"

    OtherProviderTaxonomyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OtherProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    OtherProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OtherProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OtherProviderTaxonomyName

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    OtherProviderTaxonomyName

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    OtherProviderTaxonomyName

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    OtherProviderTaxonomyName

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    OtherProviderTaxonomyName

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    OtherProviderTaxonomyName

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OtherProviderTaxonomyName

    *Not Applicable

    CMS CJR Surgical Procedure Load
    OtherProviderTaxonomyName

    *Not Applicable

    Data Aggregation ICD Procedure Load
    OtherProviderTaxonomyName

    NULL

    Data Aggregation Service Line Load
    OtherProviderTaxonomyName

    NULL

    Externally Adjudicated ICD Procedure Load
    OtherProviderTaxonomyName

    NULL

    Externally Adjudicated Service Line Load
    OtherProviderTaxonomyName

    NULL

    Payer System ICD Procedure Load
    OtherProviderTaxonomyName

    NULL

    Payer System Service Line Load
    OtherProviderTaxonomyName

    NULL

    Received Claim ICD Procedure Load
    OtherProviderTaxonomyName

    NULL

    Received Claim Procedure Load
    OtherProviderTaxonomyName

    NULL

    OrderingProviderTaxonomyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OrderingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    OrderingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OrderingProviderTaxonomyCode

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OrderingProviderTaxonomyCode

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    OrderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    OrderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    OrderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    OrderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    OrderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OrderingProviderTaxonomyCode

    *Not Applicable

    CMS CJR Surgical Procedure Load
    OrderingProviderTaxonomyCode

    *Not Applicable

    Data Aggregation ICD Procedure Load
    OrderingProviderTaxonomyCode

    *Not Applicable

    Data Aggregation Service Line Load
    OrderingProviderTaxonomyCode
    SVC_LN_INFO_3.LN_ORD_TAXONOMY
    Externally Adjudicated ICD Procedure Load
    OrderingProviderTaxonomyCode

    *Not Applicable

    Externally Adjudicated Service Line Load
    OrderingProviderTaxonomyCode

    "*Unspecified"

    Payer System ICD Procedure Load
    OrderingProviderTaxonomyCode

    *Not Applicable

    Payer System Service Line Load
    OrderingProviderTaxonomyCode
    SVC_LN_INFO_3.LN_ORD_TAXONOMY
    Received Claim ICD Procedure Load
    OrderingProviderTaxonomyCode

    *Not Applicable

    Received Claim Procedure Load
    OrderingProviderTaxonomyCode

    "*Unspecified"

    OrderingProviderTaxonomyName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    OrderingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    OrderingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B DME File Load
    OrderingProviderTaxonomyName

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    OrderingProviderTaxonomyName

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    OrderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Home Health Claim Procedure Load
    OrderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Inpatient Claim Procedure Load
    OrderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Outpatient Claim Procedure Load
    OrderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Part B Claim Procedure Load
    OrderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Skilled Nursing Claim Procedure Load
    OrderingProviderTaxonomyName

    *Not Applicable

    CMS CJR Surgical Procedure Load
    OrderingProviderTaxonomyName

    *Not Applicable

    Data Aggregation ICD Procedure Load
    OrderingProviderTaxonomyName

    NULL

    Data Aggregation Service Line Load
    OrderingProviderTaxonomyName

    NULL

    Externally Adjudicated ICD Procedure Load
    OrderingProviderTaxonomyName

    NULL

    Externally Adjudicated Service Line Load
    OrderingProviderTaxonomyName

    NULL

    Payer System ICD Procedure Load
    OrderingProviderTaxonomyName

    NULL

    Payer System Service Line Load
    OrderingProviderTaxonomyName

    NULL

    Received Claim ICD Procedure Load
    OrderingProviderTaxonomyName

    NULL

    Received Claim Procedure Load
    OrderingProviderTaxonomyName

    NULL

    Workflow

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    Workflow

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    Workflow

    "*Not Applicable"

    CMS ACO Part B DME File Load
    Workflow

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    Workflow

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    Workflow
    CMS CJR Home Health Claim Procedure Load
    Workflow
    CMS CJR Inpatient Claim Procedure Load
    Workflow
    CMS CJR Outpatient Claim Procedure Load
    Workflow
    CMS CJR Part B Claim Procedure Load
    Workflow
    CMS CJR Skilled Nursing Claim Procedure Load
    Workflow
    CMS CJR Surgical Procedure Load
    Workflow
    Data Aggregation ICD Procedure Load
    Workflow
    AP_CLAIM.WORKFLOW_C
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C

    If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME

    Data Aggregation Service Line Load
    Workflow
    AP_CLAIM.WORKFLOW_C
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C

    If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME

    Externally Adjudicated ICD Procedure Load
    Workflow
    AP_CLAIM.WORKFLOW_C
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C

    If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME

    Externally Adjudicated Service Line Load
    Workflow
    AP_CLAIM.WORKFLOW_C
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C

    If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME

    Payer System ICD Procedure Load
    Workflow
    AP_CLAIM.WORKFLOW_C
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C

    If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME

    Payer System Service Line Load
    Workflow
    AP_CLAIM.WORKFLOW_C
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C

    If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME

    Received Claim ICD Procedure Load
    Workflow
    AP_CLAIM.WORKFLOW_C
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C

    If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME

    Received Claim Procedure Load
    Workflow
    AP_CLAIM.WORKFLOW_C
    ZC_WORKFLOW.NAME
    ZC_WORKFLOW.WORKFLOW_C

    If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME

    LineProcessingStatus

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    LineProcessingStatus

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    LineProcessingStatus

    "*Not Applicable"

    CMS ACO Part B DME File Load
    LineProcessingStatus
    CmsDenialTypeCodes.CategoryName
    CmsDenialTypeCodes.Id
    CmsDenialTypeCodes.IsDenial
    MsspPartBDme.CLM_PRCSG_IND_CD

    If CLM_PRCSG_IND_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimMedicareNonPaymentReasonCode" then "*Unknown" Otherwise if IsDenial = 1 then "Denied" Otherwise "Clean"

    CMS ACO Part B Physicians File Load
    LineProcessingStatus
    CmsDenialTypeCodes.CategoryName
    CmsDenialTypeCodes.Id
    CmsDenialTypeCodes.IsDenial
    MsspPartBPhysicians.CLM_PRCSG_IND_CD

    If CLM_PRCSG_IND_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimMedicareNonPaymentReasonCode" then "*Unknown" Otherwise if IsDenial = 1 then "Denied" Otherwise "Clean"

    CMS CJR DME Claim Procedure Load
    LineProcessingStatus

    NULL

    CMS CJR Home Health Claim Procedure Load
    LineProcessingStatus

    NULL

    CMS CJR Inpatient Claim Procedure Load
    LineProcessingStatus

    NULL

    CMS CJR Outpatient Claim Procedure Load
    LineProcessingStatus

    NULL

    CMS CJR Part B Claim Procedure Load
    LineProcessingStatus

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    LineProcessingStatus

    NULL

    CMS CJR Surgical Procedure Load
    LineProcessingStatus

    NULL

    Data Aggregation ICD Procedure Load
    LineProcessingStatus
    AP_CLAIM.STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C

    If AP_CLAIM.STATUS_C is NULL then *Unspecified Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then *Unknown Otherwise ZC_CLM_STATUS.NAME

    Data Aggregation Service Line Load
    LineProcessingStatus
    AP_CLAIM.STATUS_C
    AP_CLAIM_PROC.STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C
    ZC_STATUS_4.NAME
    ZC_STATUS_4.STATUS_4_C

    If STATUS_4_C.NAME is not NULL then STATUS_4_C.NAME Otherwise if AP_CLAIM_PROC.STATUS_C is NULL then "*Unknown" Otherwise if AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME

    Externally Adjudicated ICD Procedure Load
    LineProcessingStatus
    AP_CLAIM.STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C

    If AP_CLAIM.STATUS_C is NULL then *Unspecified Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then *Unknown Otherwise ZC_CLM_STATUS.NAME

    Externally Adjudicated Service Line Load
    LineProcessingStatus
    AP_CLAIM.STATUS_C
    AP_CLAIM_PROC.STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C
    ZC_STATUS_4.NAME
    ZC_STATUS_4.STATUS_4_C

    If STATUS_4_C.NAME is not NULL then STATUS_4_C.NAME Otherwise if AP_CLAIM_PROC.STATUS_C is NULL then "*Unknown" Otherwise if AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME

    Payer System ICD Procedure Load
    LineProcessingStatus
    AP_CLAIM.STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C

    If AP_CLAIM.STATUS_C is NULL then *Unspecified Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then *Unknown Otherwise ZC_CLM_STATUS.NAME

    Payer System Service Line Load
    LineProcessingStatus
    AP_CLAIM.STATUS_C
    AP_CLAIM_PROC.STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C
    ZC_STATUS_4.NAME
    ZC_STATUS_4.STATUS_4_C

    If STATUS_4_C.NAME is not NULL then STATUS_4_C.NAME Otherwise if AP_CLAIM_PROC.STATUS_C is NULL then "*Unknown" Otherwise if AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME

    Received Claim ICD Procedure Load
    LineProcessingStatus
    AP_CLAIM.STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C

    If AP_CLAIM.STATUS_C is NULL then *Unspecified Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then *Unknown Otherwise ZC_CLM_STATUS.NAME

    Received Claim Procedure Load
    LineProcessingStatus
    AP_CLAIM.STATUS_C
    AP_CLAIM_PROC.STATUS_C
    ZC_CLM_STATUS.NAME
    ZC_CLM_STATUS.STATUS_C
    ZC_STATUS_4.NAME
    ZC_STATUS_4.STATUS_4_C

    If STATUS_4_C.NAME is not NULL then STATUS_4_C.NAME Otherwise if AP_CLAIM_PROC.STATUS_C is NULL then "*Unknown" Otherwise if AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME

    TaxIdNumber

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    empty string
    Delete value
    empty string
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TaxIdNumber

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    TaxIdNumber

    "*Not Applicable"

    CMS ACO Part B DME File Load
    TaxIdNumber

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    TaxIdNumber
    MsspPartBPhysicians.CLM_RNDRG_PRVDR_TAX_NUM
    CMS CJR DME Claim Procedure Load
    TaxIdNumber

    NULL

    CMS CJR Home Health Claim Procedure Load
    TaxIdNumber

    NULL

    CMS CJR Inpatient Claim Procedure Load
    TaxIdNumber

    NULL

    CMS CJR Outpatient Claim Procedure Load
    TaxIdNumber

    NULL

    CMS CJR Part B Claim Procedure Load
    TaxIdNumber
    CmsCjrPartBDetail.PRFTIN
    CMS CJR Skilled Nursing Claim Procedure Load
    TaxIdNumber

    NULL

    CMS CJR Surgical Procedure Load
    TaxIdNumber

    NULL

    Data Aggregation ICD Procedure Load
    TaxIdNumber
    CLM_VALUES.BIL_PROV_TAXID
    VENDOR_TAX_ID.TAX_ID

    If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID

    Data Aggregation Service Line Load
    TaxIdNumber
    CLM_VALUES.BIL_PROV_TAXID
    VENDOR_TAX_ID.TAX_ID

    If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID

    Externally Adjudicated ICD Procedure Load
    TaxIdNumber
    CLM_VALUES.BIL_PROV_TAXID
    VENDOR_TAX_ID.TAX_ID

    If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID

    Externally Adjudicated Service Line Load
    TaxIdNumber
    CLM_VALUES.BIL_PROV_TAXID
    VENDOR_TAX_ID.TAX_ID

    If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID

    Payer System ICD Procedure Load
    TaxIdNumber
    CLM_VALUES.BIL_PROV_TAXID
    VENDOR_TAX_ID.TAX_ID

    If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID

    Payer System Service Line Load
    TaxIdNumber
    CLM_VALUES.BIL_PROV_TAXID
    VENDOR_TAX_ID.TAX_ID

    If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID

    Received Claim ICD Procedure Load
    TaxIdNumber
    CLM_VALUES.BIL_PROV_TAXID
    VENDOR_TAX_ID.TAX_ID

    If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID

    Received Claim Procedure Load
    TaxIdNumber
    CLM_VALUES.BIL_PROV_TAXID
    VENDOR_TAX_ID.TAX_ID

    If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID

    Ccn

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    empty string
    Delete value
    empty string
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    Ccn
    MsspPartAClaimsDetail.PRVDR_OSCAR_NUM
    CMS ACO Part A Procedure Files Load
    Ccn
    MsspPartAProcedureCode.PRVDR_OSCAR_NUM
    CMS ACO Part B DME File Load
    Ccn

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    Ccn

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    Ccn

    NULL

    CMS CJR Home Health Claim Procedure Load
    Ccn
    CmsCjrHomeHealthHeader.CLM_PROVIDER
    CMS CJR Inpatient Claim Procedure Load
    Ccn
    CmsCjrInpatientHeader.CLM_PROVIDER
    CMS CJR Outpatient Claim Procedure Load
    Ccn
    CmsCjrOutpatientHeader.CLM_PROVIDER
    CMS CJR Part B Claim Procedure Load
    Ccn

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    Ccn
    CmsCjrSkilledNursingHeader.CLM_PROVIDER
    CMS CJR Surgical Procedure Load
    Ccn
    CmsCjrHospiceHeader.CLM_PROVIDER
    CmsCjrInpatientHeader.CLM_PROVIDER
    CmsCjrSkilledNursingHeader.CLM_PROVIDER

    If claim is inpatient, skilled nursing, or hospice then CLM_PROVIDER Otherwise NULL

    Data Aggregation ICD Procedure Load
    Ccn
    CLM_VALUES_5.SVC_FAC_CCN

    NULL

    Data Aggregation Service Line Load
    Ccn
    CLM_VALUES_5.SVC_FAC_CCN

    NULL

    Externally Adjudicated ICD Procedure Load
    Ccn

    NULL

    Externally Adjudicated Service Line Load
    Ccn

    NULL

    Payer System ICD Procedure Load
    Ccn
    CLM_VALUES_5.SVC_FAC_CCN

    NULL

    Payer System Service Line Load
    Ccn
    CLM_VALUES_5.SVC_FAC_CCN

    NULL

    Received Claim ICD Procedure Load
    Ccn

    NULL

    Received Claim Procedure Load
    Ccn

    NULL

    ServiceLineFacilityNpi

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceLineFacilityNpi
    CMS ACO Part A Procedure Files Load
    ServiceLineFacilityNpi
    CMS ACO Part B DME File Load
    ServiceLineFacilityNpi
    CMS ACO Part B Physicians File Load
    ServiceLineFacilityNpi
    CMS CJR DME Claim Procedure Load
    ServiceLineFacilityNpi
    CMS CJR Home Health Claim Procedure Load
    ServiceLineFacilityNpi
    CMS CJR Inpatient Claim Procedure Load
    ServiceLineFacilityNpi
    CMS CJR Outpatient Claim Procedure Load
    ServiceLineFacilityNpi
    CMS CJR Part B Claim Procedure Load
    ServiceLineFacilityNpi
    CMS CJR Skilled Nursing Claim Procedure Load
    ServiceLineFacilityNpi
    CMS CJR Surgical Procedure Load
    ServiceLineFacilityNpi
    Data Aggregation Service Line Load
    ServiceLineFacilityNpi
    SVC_LN_INFO.LN_SVC_FAC_NPI
    Externally Adjudicated ICD Procedure Load
    ServiceLineFacilityNpi

    "*Not Applicable"

    Externally Adjudicated Service Line Load
    ServiceLineFacilityNpi
    SVC_LN_INFO.LN_SVC_FAC_NPI
    Payer System Service Line Load
    ServiceLineFacilityNpi
    SVC_LN_INFO.LN_SVC_FAC_NPI
    Received Claim ICD Procedure Load
    ServiceLineFacilityNpi
    Received Claim Procedure Load
    ServiceLineFacilityNpi
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_SVC_FAC_NPI

    If the number of services has not been modified in the system then LN_SVC_FAC_NPI

    ServiceLineFacilityName

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(100)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceLineFacilityName
    CMS ACO Part A Procedure Files Load
    ServiceLineFacilityName
    CMS ACO Part B DME File Load
    ServiceLineFacilityName
    CMS ACO Part B Physicians File Load
    ServiceLineFacilityName
    CMS CJR DME Claim Procedure Load
    ServiceLineFacilityName
    CMS CJR Home Health Claim Procedure Load
    ServiceLineFacilityName
    CMS CJR Inpatient Claim Procedure Load
    ServiceLineFacilityName
    CMS CJR Outpatient Claim Procedure Load
    ServiceLineFacilityName
    CMS CJR Part B Claim Procedure Load
    ServiceLineFacilityName
    CMS CJR Skilled Nursing Claim Procedure Load
    ServiceLineFacilityName
    CMS CJR Surgical Procedure Load
    ServiceLineFacilityName
    Data Aggregation Service Line Load
    ServiceLineFacilityName
    SVC_LN_INFO.LN_SVC_FAC_NAM
    Externally Adjudicated ICD Procedure Load
    ServiceLineFacilityName

    "*Not Applicable"

    Externally Adjudicated Service Line Load
    ServiceLineFacilityName
    SVC_LN_INFO.LN_SVC_FAC_NAM
    Payer System Service Line Load
    ServiceLineFacilityName
    SVC_LN_INFO.LN_SVC_FAC_NAM
    Received Claim ICD Procedure Load
    ServiceLineFacilityName

    "*Not Applicable"

    Received Claim Procedure Load
    ServiceLineFacilityName
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_SVC_FAC_NAM

    If the number of services has not been modified in the system then LN_SVC_FAC_NAM

    ServiceLineFacilityAddress

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(250)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceLineFacilityAddress
    CMS ACO Part A Procedure Files Load
    ServiceLineFacilityAddress
    CMS ACO Part B DME File Load
    ServiceLineFacilityAddress
    CMS ACO Part B Physicians File Load
    ServiceLineFacilityAddress
    CMS CJR DME Claim Procedure Load
    ServiceLineFacilityAddress
    CMS CJR Home Health Claim Procedure Load
    ServiceLineFacilityAddress
    CMS CJR Inpatient Claim Procedure Load
    ServiceLineFacilityAddress
    CMS CJR Outpatient Claim Procedure Load
    ServiceLineFacilityAddress
    CMS CJR Part B Claim Procedure Load
    ServiceLineFacilityAddress
    CMS CJR Skilled Nursing Claim Procedure Load
    ServiceLineFacilityAddress
    CMS CJR Surgical Procedure Load
    ServiceLineFacilityAddress
    Data Aggregation Service Line Load
    ServiceLineFacilityAddress
    SVC_LN_INFO.LN_SVC_FAC_ADDR_1
    SVC_LN_INFO.LN_SVC_FAC_ADDR_2

    If LN_SVC_FAC_ADDR_1 is NULL then LN_SVC_FAC_ADDR_2 Otherwise if LN_SVC_FAC_ADDR_2 is NULL then LN_SVC_FAC_ADDR_1 Otherwise LN_SVC_FAC_ADDR_1 + " " + LN_SVC_FAC_ADDR_2

    Externally Adjudicated ICD Procedure Load
    ServiceLineFacilityAddress

    "*Not Applicable"

    Externally Adjudicated Service Line Load
    ServiceLineFacilityAddress
    SVC_LN_INFO.LN_SVC_FAC_ADDR_1
    SVC_LN_INFO.LN_SVC_FAC_ADDR_2

    If LN_SVC_FAC_ADDR_1 is NULL then LN_SVC_FAC_ADDR_2 Otherwise if LN_SVC_FAC_ADDR_2 is NULL then LN_SVC_FAC_ADDR_1 Otherwise LN_SVC_FAC_ADDR_1 + " " + LN_SVC_FAC_ADDR_2

    Payer System Service Line Load
    ServiceLineFacilityAddress
    SVC_LN_INFO.LN_SVC_FAC_ADDR_1
    SVC_LN_INFO.LN_SVC_FAC_ADDR_2

    If LN_SVC_FAC_ADDR_1 is NULL then LN_SVC_FAC_ADDR_2 Otherwise if LN_SVC_FAC_ADDR_2 is NULL then LN_SVC_FAC_ADDR_1 Otherwise LN_SVC_FAC_ADDR_1 + " " + LN_SVC_FAC_ADDR_2

    Received Claim ICD Procedure Load
    ServiceLineFacilityAddress

    "*Not Applicable"

    Received Claim Procedure Load
    ServiceLineFacilityAddress
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_SVC_FAC_ADDR_1
    SVC_LN_INFO.LN_SVC_FAC_ADDR_2

    If LN_SVC_FAC_ADDR_1 is NULL and the number of services has not been modified in the system then LN_SVC_FAC_ADDR_2 Otherwise if LN_SVC_FAC_ADDR_2 is NULL and the number of services has not been modified in the system then LN_SVC_FAC_ADDR_1 Otherwise if the number of services has not been modified in the system then LN_SVC_FAC_ADDR_1 + " " + LN_SVC_FAC_ADDR_2

    ServiceLineFacilityCity

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(100)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceLineFacilityCity
    CMS ACO Part A Procedure Files Load
    ServiceLineFacilityCity
    CMS ACO Part B DME File Load
    ServiceLineFacilityCity
    CMS ACO Part B Physicians File Load
    ServiceLineFacilityCity
    CMS CJR DME Claim Procedure Load
    ServiceLineFacilityCity
    CMS CJR Home Health Claim Procedure Load
    ServiceLineFacilityCity
    CMS CJR Inpatient Claim Procedure Load
    ServiceLineFacilityCity
    CMS CJR Outpatient Claim Procedure Load
    ServiceLineFacilityCity
    CMS CJR Part B Claim Procedure Load
    ServiceLineFacilityCity
    CMS CJR Skilled Nursing Claim Procedure Load
    ServiceLineFacilityCity
    CMS CJR Surgical Procedure Load
    ServiceLineFacilityCity
    Data Aggregation Service Line Load
    ServiceLineFacilityCity
    SVC_LN_INFO.LN_SVC_FAC_CITY
    Externally Adjudicated ICD Procedure Load
    ServiceLineFacilityCity

    "*Not Applicable"

    Externally Adjudicated Service Line Load
    ServiceLineFacilityCity
    SVC_LN_INFO.LN_SVC_FAC_CITY
    Payer System Service Line Load
    ServiceLineFacilityCity
    SVC_LN_INFO.LN_SVC_FAC_CITY
    Received Claim ICD Procedure Load
    ServiceLineFacilityCity

    "*Not Applicable"

    Received Claim Procedure Load
    ServiceLineFacilityCity
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_SVC_FAC_CITY

    If the number of services has not been modified in the system then LN_SVC_FAC_CITY

    ServiceLineFacilityStateOrProvince

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceLineFacilityStateOrProvince
    CMS ACO Part A Procedure Files Load
    ServiceLineFacilityStateOrProvince
    CMS ACO Part B DME File Load
    ServiceLineFacilityStateOrProvince
    CMS ACO Part B Physicians File Load
    ServiceLineFacilityStateOrProvince
    CMS CJR DME Claim Procedure Load
    ServiceLineFacilityStateOrProvince
    CMS CJR Home Health Claim Procedure Load
    ServiceLineFacilityStateOrProvince
    CMS CJR Inpatient Claim Procedure Load
    ServiceLineFacilityStateOrProvince
    CMS CJR Outpatient Claim Procedure Load
    ServiceLineFacilityStateOrProvince
    CMS CJR Part B Claim Procedure Load
    ServiceLineFacilityStateOrProvince
    CMS CJR Skilled Nursing Claim Procedure Load
    ServiceLineFacilityStateOrProvince
    CMS CJR Surgical Procedure Load
    ServiceLineFacilityStateOrProvince
    Data Aggregation Service Line Load
    ServiceLineFacilityStateOrProvince
    SVC_LN_INFO.LN_SVC_FAC_STATE
    Externally Adjudicated ICD Procedure Load
    ServiceLineFacilityStateOrProvince

    "*Not Applicable"

    Externally Adjudicated Service Line Load
    ServiceLineFacilityStateOrProvince
    SVC_LN_INFO.LN_SVC_FAC_STATE
    Payer System Service Line Load
    ServiceLineFacilityStateOrProvince
    SVC_LN_INFO.LN_SVC_FAC_STATE
    Received Claim ICD Procedure Load
    ServiceLineFacilityStateOrProvince

    "*Not Applicable"

    Received Claim Procedure Load
    ServiceLineFacilityStateOrProvince
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_SVC_FAC_STATE

    If the number of services has not been modified in the system then LN_SVC_FAC_STATE

    ServiceLineFacilityPostalCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceLineFacilityPostalCode
    CMS ACO Part A Procedure Files Load
    ServiceLineFacilityPostalCode
    CMS ACO Part B DME File Load
    ServiceLineFacilityPostalCode
    CMS ACO Part B Physicians File Load
    ServiceLineFacilityPostalCode
    CMS CJR DME Claim Procedure Load
    ServiceLineFacilityPostalCode
    CMS CJR Home Health Claim Procedure Load
    ServiceLineFacilityPostalCode
    CMS CJR Inpatient Claim Procedure Load
    ServiceLineFacilityPostalCode
    CMS CJR Outpatient Claim Procedure Load
    ServiceLineFacilityPostalCode
    CMS CJR Part B Claim Procedure Load
    ServiceLineFacilityPostalCode
    CMS CJR Skilled Nursing Claim Procedure Load
    ServiceLineFacilityPostalCode
    CMS CJR Surgical Procedure Load
    ServiceLineFacilityPostalCode
    Data Aggregation Service Line Load
    ServiceLineFacilityPostalCode
    SVC_LN_INFO.LN_SVC_FAC_ZIP
    Externally Adjudicated ICD Procedure Load
    ServiceLineFacilityPostalCode

    "*Not Applicable"

    Externally Adjudicated Service Line Load
    ServiceLineFacilityPostalCode
    SVC_LN_INFO.LN_SVC_FAC_ZIP
    Payer System Service Line Load
    ServiceLineFacilityPostalCode
    SVC_LN_INFO.LN_SVC_FAC_ZIP
    Received Claim ICD Procedure Load
    ServiceLineFacilityPostalCode

    "*Not Applicable"

    Received Claim Procedure Load
    ServiceLineFacilityPostalCode
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_SVC_FAC_ZIP

    If the number of services has not been modified in the system then LN_SVC_FAC_ZIP

    ServiceLineFacilityCountry

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ServiceLineFacilityCountry
    CMS ACO Part A Procedure Files Load
    ServiceLineFacilityCountry
    CMS ACO Part B DME File Load
    ServiceLineFacilityCountry
    CMS ACO Part B Physicians File Load
    ServiceLineFacilityCountry
    CMS CJR DME Claim Procedure Load
    ServiceLineFacilityCountry
    CMS CJR Home Health Claim Procedure Load
    ServiceLineFacilityCountry
    CMS CJR Inpatient Claim Procedure Load
    ServiceLineFacilityCountry
    CMS CJR Outpatient Claim Procedure Load
    ServiceLineFacilityCountry
    CMS CJR Part B Claim Procedure Load
    ServiceLineFacilityCountry
    CMS CJR Skilled Nursing Claim Procedure Load
    ServiceLineFacilityCountry
    CMS CJR Surgical Procedure Load
    ServiceLineFacilityCountry
    Data Aggregation Service Line Load
    ServiceLineFacilityCountry
    SVC_LN_INFO.LN_SVC_FAC_CNTRY
    Externally Adjudicated ICD Procedure Load
    ServiceLineFacilityCountry

    "*Not Applicable"

    Externally Adjudicated Service Line Load
    ServiceLineFacilityCountry
    SVC_LN_INFO.LN_SVC_FAC_CNTRY
    Payer System Service Line Load
    ServiceLineFacilityCountry
    SVC_LN_INFO.LN_SVC_FAC_CNTRY
    Received Claim ICD Procedure Load
    ServiceLineFacilityCountry

    "*Not Applicable"

    Received Claim Procedure Load
    ServiceLineFacilityCountry
    AP_CLAIM_PROC.TX_ID
    AP_CLAIM_TX_HX.CLAIM_ID
    SVC_LN_INFO.LINE
    SVC_LN_INFO.LN_SVC_FAC_CNTRY

    If the number of services has not been modified in the system then LN_SVC_FAC_CNTRY

    DetailedServiceClass

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(300)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    *Deleted
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DetailedServiceClass

    "*Not Applicable"

    CMS ACO Part A Procedure Files Load
    DetailedServiceClass

    "*Not Applicable"

    CMS ACO Part B DME File Load
    DetailedServiceClass

    "*Not Applicable"

    CMS ACO Part B Physicians File Load
    DetailedServiceClass

    "*Not Applicable"

    CMS CJR DME Claim Procedure Load
    DetailedServiceClass

    "*Not Applicable"

    CMS CJR Home Health Claim Procedure Load
    DetailedServiceClass

    "*Not Applicable"

    CMS CJR Inpatient Claim Procedure Load
    DetailedServiceClass

    "*Not Applicable"

    CMS CJR Outpatient Claim Procedure Load
    DetailedServiceClass

    "*Not Applicable"

    CMS CJR Part B Claim Procedure Load
    DetailedServiceClass

    "*Not Applicable"

    CMS CJR Skilled Nursing Claim Procedure Load
    DetailedServiceClass

    "*Not Applicable"

    CMS CJR Surgical Procedure Load
    DetailedServiceClass

    "*Not Applicable"

    Data Aggregation Service Line Load
    DetailedServiceClass
    AP_CLAIM_PROC_2.CLAIM_LN_DTL_SVC_CLASS_C
    ZC_CLAIM_LN_DTL_SVC_CLASS.CLAIM_LN_DTL_SVC_CLASS_C
    ZC_CLAIM_LN_DTL_SVC_CLASS.NAME
    Externally Adjudicated ICD Procedure Load
    DetailedServiceClass

    "*Not Applicable"

    Externally Adjudicated Service Line Load
    DetailedServiceClass
    AP_CLAIM_PROC_2.CLAIM_LN_DTL_SVC_CLASS_C
    ZC_CLAIM_LN_DTL_SVC_CLASS.CLAIM_LN_DTL_SVC_CLASS_C
    ZC_CLAIM_LN_DTL_SVC_CLASS.NAME

    If AP_CLAIM_PROC_2.CLAIM_LN_DTL_SVC_CLASS_C is NULL then "*Unspecified" Otherwise if ZC_CLAIM_LN_DTL_SVC_CLASS.CLAIM_LN_DTL_SVC_CLASS_C is NULL then "*Unknown" Otherwise ZC_CLAIM_LN_DTL_SVC_CLASS.NAME

    Payer System Service Line Load
    DetailedServiceClass
    AP_CLAIM_PROC_2.CLAIM_LN_DTL_SVC_CLASS_C
    ZC_CLAIM_LN_DTL_SVC_CLASS.CLAIM_LN_DTL_SVC_CLASS_C
    ZC_CLAIM_LN_DTL_SVC_CLASS.NAME
    Received Claim ICD Procedure Load
    DetailedServiceClass

    "*Not Applicable"

    Received Claim Procedure Load
    DetailedServiceClass
    AP_CLAIM_PROC_2.CLAIM_LN_DTL_SVC_CLASS_C
    ZC_CLAIM_LN_DTL_SVC_CLASS.CLAIM_LN_DTL_SVC_CLASS_C
    ZC_CLAIM_LN_DTL_SVC_CLASS.NAME

    If AP_CLAIM_PROC_2.CLAIM_LN_DTL_SVC_CLASS_C is NULL then "*Unspecified" Otherwise if ZC_CLAIM_LN_DTL_SVC_CLASS.CLAIM_LN_DTL_SVC_CLASS_C is NULL then "*Unknown" Otherwise ZC_CLAIM_LN_DTL_SVC_CLASS.NAME

    TypeOfBillFacilityTypeCode

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS ACO Part A Procedure Files Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS ACO Part B DME File Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS ACO Part B Physicians File Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS CJR DME Claim Procedure Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS CJR Home Health Claim Procedure Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS CJR Inpatient Claim Procedure Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS CJR Outpatient Claim Procedure Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS CJR Part B Claim Procedure Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    TypeOfBillFacilityTypeCode

    NULL

    CMS CJR Surgical Procedure Load
    TypeOfBillFacilityTypeCode

    NULL

    Data Aggregation ICD Procedure Load
    TypeOfBillFacilityTypeCode

    NULL

    Data Aggregation Service Line Load
    TypeOfBillFacilityTypeCode

    NULL

    Externally Adjudicated ICD Procedure Load
    TypeOfBillFacilityTypeCode

    NULL

    Externally Adjudicated Service Line Load
    TypeOfBillFacilityTypeCode

    NULL

    Payer System ICD Procedure Load
    TypeOfBillFacilityTypeCode

    NULL

    Payer System Service Line Load
    TypeOfBillFacilityTypeCode

    NULL

    Received Claim ICD Procedure Load
    TypeOfBillFacilityTypeCode

    NULL

    Received Claim Procedure Load
    TypeOfBillFacilityTypeCode

    NULL

    TypeOfBillServiceTypeCode

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TypeOfBillServiceTypeCode

    NULL

    CMS ACO Part A Procedure Files Load
    TypeOfBillServiceTypeCode

    NULL

    CMS ACO Part B DME File Load
    TypeOfBillServiceTypeCode

    NULL

    CMS ACO Part B Physicians File Load
    TypeOfBillServiceTypeCode

    NULL

    CMS CJR DME Claim Procedure Load
    TypeOfBillServiceTypeCode

    NULL

    CMS CJR Home Health Claim Procedure Load
    TypeOfBillServiceTypeCode

    NULL

    CMS CJR Inpatient Claim Procedure Load
    TypeOfBillServiceTypeCode

    NULL

    CMS CJR Outpatient Claim Procedure Load
    TypeOfBillServiceTypeCode

    NULL

    CMS CJR Part B Claim Procedure Load
    TypeOfBillServiceTypeCode

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    TypeOfBillServiceTypeCode

    NULL

    CMS CJR Surgical Procedure Load
    TypeOfBillServiceTypeCode

    NULL

    Data Aggregation ICD Procedure Load
    TypeOfBillServiceTypeCode

    NULL

    Data Aggregation Service Line Load
    TypeOfBillServiceTypeCode

    NULL

    Externally Adjudicated ICD Procedure Load
    TypeOfBillServiceTypeCode

    NULL

    Externally Adjudicated Service Line Load
    TypeOfBillServiceTypeCode

    NULL

    Payer System ICD Procedure Load
    TypeOfBillServiceTypeCode

    NULL

    Payer System Service Line Load
    TypeOfBillServiceTypeCode

    NULL

    Received Claim ICD Procedure Load
    TypeOfBillServiceTypeCode

    NULL

    Received Claim Procedure Load
    TypeOfBillServiceTypeCode

    NULL

    TypeOfBillFrequencyCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    empty string
    Delete value
    empty string
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    TypeOfBillFrequencyCode

    NULL

    CMS ACO Part A Procedure Files Load
    TypeOfBillFrequencyCode

    NULL

    CMS ACO Part B DME File Load
    TypeOfBillFrequencyCode

    NULL

    CMS ACO Part B Physicians File Load
    TypeOfBillFrequencyCode

    NULL

    CMS CJR DME Claim Procedure Load
    TypeOfBillFrequencyCode

    NULL

    CMS CJR Home Health Claim Procedure Load
    TypeOfBillFrequencyCode

    NULL

    CMS CJR Inpatient Claim Procedure Load
    TypeOfBillFrequencyCode

    NULL

    CMS CJR Outpatient Claim Procedure Load
    TypeOfBillFrequencyCode

    NULL

    CMS CJR Part B Claim Procedure Load
    TypeOfBillFrequencyCode

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    TypeOfBillFrequencyCode

    NULL

    CMS CJR Surgical Procedure Load
    TypeOfBillFrequencyCode

    NULL

    Data Aggregation ICD Procedure Load
    TypeOfBillFrequencyCode

    NULL

    Data Aggregation Service Line Load
    TypeOfBillFrequencyCode

    NULL

    Externally Adjudicated ICD Procedure Load
    TypeOfBillFrequencyCode

    NULL

    Externally Adjudicated Service Line Load
    TypeOfBillFrequencyCode

    NULL

    Payer System ICD Procedure Load
    TypeOfBillFrequencyCode

    NULL

    Payer System Service Line Load
    TypeOfBillFrequencyCode

    NULL

    Received Claim ICD Procedure Load
    TypeOfBillFrequencyCode

    NULL

    Received Claim Procedure Load
    TypeOfBillFrequencyCode

    NULL

    PlaceOfServiceTypeCode

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    empty string
    Delete value
    empty string
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PlaceOfServiceTypeCode

    NULL

    CMS ACO Part A Procedure Files Load
    PlaceOfServiceTypeCode

    "*Not Applicable"

    CMS ACO Part B DME File Load
    PlaceOfServiceTypeCode
    MsspPartBDme.CLM_POS_CD
    CMS ACO Part B Physicians File Load
    PlaceOfServiceTypeCode
    MsspPartBPhysicians.CLM_POS_CD
    CMS CJR DME Claim Procedure Load
    PlaceOfServiceTypeCode
    CmsCjrDmeDetail.PLCSRVC
    CMS CJR Home Health Claim Procedure Load
    PlaceOfServiceTypeCode

    NULL

    CMS CJR Inpatient Claim Procedure Load
    PlaceOfServiceTypeCode

    NULL

    CMS CJR Outpatient Claim Procedure Load
    PlaceOfServiceTypeCode

    NULL

    CMS CJR Part B Claim Procedure Load
    PlaceOfServiceTypeCode

    CmsCjrPartBDetail.PLCSRVC

    CMS CJR Skilled Nursing Claim Procedure Load
    PlaceOfServiceTypeCode

    NULL

    CMS CJR Surgical Procedure Load
    PlaceOfServiceTypeCode

    NULL

    Data Aggregation ICD Procedure Load
    PlaceOfServiceTypeCode

    NULL

    Data Aggregation Service Line Load
    PlaceOfServiceTypeCode
    AP_CLAIM_PROC.POS_TYPE_C
    ZC_POS_TYPE.ABBR
    Externally Adjudicated ICD Procedure Load
    PlaceOfServiceTypeCode

    NULL

    Externally Adjudicated Service Line Load
    PlaceOfServiceTypeCode
    AP_CLAIM_PROC.POS_TYPE_C
    ZC_POS_TYPE.ABBR
    Payer System ICD Procedure Load
    PlaceOfServiceTypeCode

    NULL

    Payer System Service Line Load
    PlaceOfServiceTypeCode
    AP_CLAIM_PROC.POS_TYPE_C
    ZC_POS_TYPE.ABBR
    Received Claim ICD Procedure Load
    PlaceOfServiceTypeCode

    NULL

    Received Claim Procedure Load
    PlaceOfServiceTypeCode
    AP_CLAIM_PROC.POS_TYPE_C
    ZC_POS_TYPE.ABBR

    IcdProcedureRank

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    int
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IcdProcedureRank

    NULL

    CMS ACO Part A Procedure Files Load
    IcdProcedureRank
    MsspPartAProcedureCode.CLM_VAL_SQNC_NUM
    CMS ACO Part B DME File Load
    IcdProcedureRank

    NULL

    CMS ACO Part B Physicians File Load
    IcdProcedureRank

    NULL

    CMS CJR DME Claim Procedure Load
    IcdProcedureRank

    NULL

    CMS CJR Home Health Claim Procedure Load
    IcdProcedureRank

    NULL

    CMS CJR Inpatient Claim Procedure Load
    IcdProcedureRank

    NULL

    CMS CJR Outpatient Claim Procedure Load
    IcdProcedureRank

    NULL

    CMS CJR Part B Claim Procedure Load
    IcdProcedureRank

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    IcdProcedureRank

    NULL

    CMS CJR Surgical Procedure Load
    IcdProcedureRank
    CmsCjrDiagnosesProcedures.CLM_VAL_SQNC_NUM
    Data Aggregation ICD Procedure Load
    IcdProcedureRank
    AP_CLAIM_ICD_PROC.ICD_PX_RANK
    Data Aggregation Service Line Load
    IcdProcedureRank

    NULL

    Externally Adjudicated ICD Procedure Load
    IcdProcedureRank
    AP_CLAIM_ICD_PROC.LINE
    Externally Adjudicated Service Line Load
    IcdProcedureRank

    NULL

    Payer System ICD Procedure Load
    IcdProcedureRank
    AP_CLAIM_ICD_PROC.ICD_PX_RANK
    Payer System Service Line Load
    IcdProcedureRank

    NULL

    Received Claim ICD Procedure Load
    IcdProcedureRank
    AP_CLAIM_ICD_PROC.LINE
    Received Claim Procedure Load
    IcdProcedureRank

    NULL

    Quantity

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,4)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    Quantity
    MsspPartAClaimsDetail.CLM_ADJSMT_TYPE_CD
    MsspPartAClaimsDetail.CLM_LINE_ALOWD_UNIT_QTY

    If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_ALOWD_UNIT_QTY × (-1) Otherwise CLM_LINE_ALOWD_UNIT_QTY

    CMS ACO Part A Procedure Files Load
    Quantity

    NULL

    CMS ACO Part B DME File Load
    Quantity

    NULL

    CMS ACO Part B Physicians File Load
    Quantity
    MsspPartBPhysicians.CLM_ADJSMT_TYPE_CD
    MsspPartBPhysicians.CLM_LINE_ALOWD_UNIT_QTY

    If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_ALOWD_UNIT_QTY × (-1) Otherwise CLM_LINE_ALOWD_UNIT_QTY

    CMS CJR DME Claim Procedure Load
    Quantity
    CmsCjrDmeDetail.SRVC_CNT
    CMS CJR Home Health Claim Procedure Load
    Quantity
    CmsCjrHomeHealthDetail.REV_UNIT
    CMS CJR Inpatient Claim Procedure Load
    Quantity
    CmsCjrInpatientDetail.REV_UNIT
    CMS CJR Outpatient Claim Procedure Load
    Quantity
    CmsCjrOutpatientDetail.REV_UNIT
    CMS CJR Part B Claim Procedure Load
    Quantity
    CmsCjrPartBDetail.MTUS_CNT
    CMS CJR Skilled Nursing Claim Procedure Load
    Quantity
    CmsCjrSkilledNursingDetail.REV_UNIT
    CMS CJR Surgical Procedure Load
    Quantity

    NULL

    Data Aggregation Service Line Load
    Quantity
    AP_CLAIM_PROC.QUANTITY
    Externally Adjudicated ICD Procedure Load
    Quantity

    NULL

    Externally Adjudicated Service Line Load
    Quantity
    AP_CLAIM_PROC.QUANTITY
    Payer System Service Line Load
    Quantity
    AP_CLAIM_PROC.QUANTITY
    Received Claim ICD Procedure Load
    Quantity

    NULL

    Received Claim Procedure Load
    Quantity
    AP_CLAIM_PROC.QUANTITY

    BilledAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    BilledAmount

    NULL

    CMS ACO Part A Procedure Files Load
    BilledAmount

    NULL

    CMS ACO Part B DME File Load
    BilledAmount

    NULL

    CMS ACO Part B Physicians File Load
    BilledAmount

    NULL

    CMS CJR DME Claim Procedure Load
    BilledAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    BilledAmount
    CmsCjrHomeHealthDetail.REV_CHRG
    CMS CJR Inpatient Claim Procedure Load
    BilledAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    BilledAmount

    NULL

    CMS CJR Part B Claim Procedure Load
    BilledAmount

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    BilledAmount

    NULL

    CMS CJR Surgical Procedure Load
    BilledAmount

    NULL

    Data Aggregation ICD Procedure Load
    BilledAmount

    NULL

    Data Aggregation Service Line Load
    BilledAmount
    AP_CLAIM_PROC.BILLED_AMT
    Externally Adjudicated ICD Procedure Load
    BilledAmount

    NULL

    Externally Adjudicated Service Line Load
    BilledAmount
    AP_CLAIM_PROC.BILLED_AMT
    Payer System ICD Procedure Load
    BilledAmount

    NULL

    Payer System Service Line Load
    BilledAmount
    AP_CLAIM_PROC.BILLED_AMT
    Received Claim ICD Procedure Load
    BilledAmount

    NULL

    Received Claim Procedure Load
    BilledAmount
    AP_CLAIM_PROC.BILLED_AMT

    DiscountAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DiscountAmount

    NULL

    CMS ACO Part A Procedure Files Load
    DiscountAmount

    NULL

    CMS ACO Part B DME File Load
    DiscountAmount

    NULL

    CMS ACO Part B Physicians File Load
    DiscountAmount

    NULL

    CMS CJR DME Claim Procedure Load
    DiscountAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    DiscountAmount

    NULL

    CMS CJR Inpatient Claim Procedure Load
    DiscountAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    DiscountAmount

    NULL

    CMS CJR Part B Claim Procedure Load
    DiscountAmount

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    DiscountAmount

    NULL

    CMS CJR Surgical Procedure Load
    DiscountAmount

    NULL

    Data Aggregation ICD Procedure Load
    DiscountAmount

    NULL

    Data Aggregation Service Line Load
    DiscountAmount
    AP_CLAIM_PROC.DISCOUNT
    Externally Adjudicated ICD Procedure Load
    DiscountAmount

    NULL

    Externally Adjudicated Service Line Load
    DiscountAmount
    AP_CLAIM_PROC.DISCOUNT
    Payer System ICD Procedure Load
    DiscountAmount

    NULL

    Payer System Service Line Load
    DiscountAmount
    AP_CLAIM_PROC.DISCOUNT
    Received Claim ICD Procedure Load
    DiscountAmount

    NULL

    Received Claim Procedure Load
    DiscountAmount
    AP_CLAIM_PROC.DISCOUNT

    AllowedAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AllowedAmount

    NULL

    CMS ACO Part A Procedure Files Load
    AllowedAmount

    NULL

    CMS ACO Part B DME File Load
    AllowedAmount
    MsspPartBDme.CLM_ADJSMT_TYPE_CD
    MsspPartBDme.CLM_LINE_ALOWD_CHRG_AMT

    If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_ALOWD_CHRG_AMT × (-1) Otherwise CLM_LINE_ALOWD_CHRG_AMT

    CMS ACO Part B Physicians File Load
    AllowedAmount
    MsspPartBPhysicians.CLM_ADJSMT_TYPE_CD
    MsspPartBPhysicians.CLM_LINE_ALOWD_CHRG_AMT

    If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_ALOWD_CHRG_AMT × (-1) Otherwise CLM_LINE_ALOWD_CHRG_AMT

    CMS CJR DME Claim Procedure Load
    AllowedAmount
    CmsCjrDmeDetail.LALOWCHG
    CMS CJR Home Health Claim Procedure Load
    AllowedAmount

    NULL

    CMS CJR Inpatient Claim Procedure Load
    AllowedAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    AllowedAmount

    NULL

    CMS CJR Part B Claim Procedure Load
    AllowedAmount
    CmsCjrPartBDetail.LALOWCHG
    CMS CJR Skilled Nursing Claim Procedure Load
    AllowedAmount

    NULL

    CMS CJR Surgical Procedure Load
    AllowedAmount

    NULL

    Data Aggregation ICD Procedure Load
    AllowedAmount

    NULL

    Data Aggregation Service Line Load
    AllowedAmount
    AP_CLAIM_PROC.ALLOWED_AMT
    AP_CLAIM_PROC.OVERRIDE_ALLD_AMT

    If OVERRIDE_ALLD_AMT is not NULL then OVERRIDE_ALLD_AMT Otherwise ALLOWED_AMT

    Externally Adjudicated ICD Procedure Load
    AllowedAmount

    NULL

    Externally Adjudicated Service Line Load
    AllowedAmount
    AP_CLAIM_PROC.ALLOWED_AMT
    AP_CLAIM_PROC.OVERRIDE_ALLD_AMT

    If OVERRIDE_ALLD_AMT is not NULL then OVERRIDE_ALLD_AMT Otherwise ALLOWED_AMT

    Payer System ICD Procedure Load
    AllowedAmount

    NULL

    Payer System Service Line Load
    AllowedAmount
    AP_CLAIM_PROC.ALLOWED_AMT
    AP_CLAIM_PROC.OVERRIDE_ALLD_AMT

    If OVERRIDE_ALLD_AMT is not NULL then OVERRIDE_ALLD_AMT Otherwise ALLOWED_AMT

    Received Claim ICD Procedure Load
    AllowedAmount

    NULL

    Received Claim Procedure Load
    AllowedAmount
    AP_CLAIM_PROC.ALLOWED_AMT
    AP_CLAIM_PROC.OVERRIDE_ALLD_AMT

    If OVERRIDE_ALLD_AMT is not NULL then OVERRIDE_ALLD_AMT Otherwise ALLOWED_AMT

    CopayAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    CopayAmount

    NULL

    CMS ACO Part A Procedure Files Load
    CopayAmount

    NULL

    CMS ACO Part B DME File Load
    CopayAmount

    NULL

    CMS ACO Part B Physicians File Load
    CopayAmount

    NULL

    CMS CJR DME Claim Procedure Load
    CopayAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    CopayAmount

    NULL

    CMS CJR Inpatient Claim Procedure Load
    CopayAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    CopayAmount

    NULL

    CMS CJR Part B Claim Procedure Load
    CopayAmount

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    CopayAmount

    NULL

    CMS CJR Surgical Procedure Load
    CopayAmount

    NULL

    Data Aggregation ICD Procedure Load
    CopayAmount

    NULL

    Data Aggregation Service Line Load
    CopayAmount
    AP_CLAIM_PROC.COPAYMENT
    AP_CLAIM_PROC.OVRD_COPAY

    If OVRD_COPAY is not NULL then OVRD_COPAY Otherwise COPAYMENT

    Externally Adjudicated ICD Procedure Load
    CopayAmount

    NULL

    Externally Adjudicated Service Line Load
    CopayAmount
    AP_CLAIM_PROC.COPAYMENT
    AP_CLAIM_PROC.OVRD_COPAY

    If OVRD_COPAY is not NULL then OVRD_COPAY Otherwise COPAYMENT

    Payer System ICD Procedure Load
    CopayAmount

    NULL

    Payer System Service Line Load
    CopayAmount
    AP_CLAIM_PROC.COPAYMENT
    AP_CLAIM_PROC.OVRD_COPAY

    If OVRD_COPAY is not NULL then OVRD_COPAY Otherwise COPAYMENT

    Received Claim ICD Procedure Load
    CopayAmount

    NULL

    Received Claim Procedure Load
    CopayAmount
    AP_CLAIM_PROC.COPAYMENT
    AP_CLAIM_PROC.OVRD_COPAY

    If OVRD_COPAY is not NULL then OVRD_COPAY Otherwise COPAYMENT

    CoinsuranceAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    CoinsuranceAmount

    NULL

    CMS ACO Part A Procedure Files Load
    CoinsuranceAmount

    NULL

    CMS ACO Part B DME File Load
    CoinsuranceAmount

    NULL

    CMS ACO Part B Physicians File Load
    CoinsuranceAmount

    NULL

    CMS CJR DME Claim Procedure Load
    CoinsuranceAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    CoinsuranceAmount

    NULL

    CMS CJR Inpatient Claim Procedure Load
    CoinsuranceAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    CoinsuranceAmount

    NULL

    CMS CJR Part B Claim Procedure Load
    CoinsuranceAmount

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    CoinsuranceAmount

    NULL

    CMS CJR Surgical Procedure Load
    CoinsuranceAmount

    NULL

    Data Aggregation ICD Procedure Load
    CoinsuranceAmount

    NULL

    Data Aggregation Service Line Load
    CoinsuranceAmount
    AP_CLAIM_PROC.COINSURANCE
    AP_CLAIM_PROC.OVRD_COINS

    If OVRD_COINS is not NULL then OVRD_COINS Otherwise COINSURANCE

    Externally Adjudicated ICD Procedure Load
    CoinsuranceAmount

    NULL

    Externally Adjudicated Service Line Load
    CoinsuranceAmount
    AP_CLAIM_PROC.COINSURANCE
    AP_CLAIM_PROC.OVRD_COINS

    If OVRD_COINS is not NULL then OVRD_COINS Otherwise COINSURANCE

    Payer System ICD Procedure Load
    CoinsuranceAmount

    NULL

    Payer System Service Line Load
    CoinsuranceAmount
    AP_CLAIM_PROC.COINSURANCE
    AP_CLAIM_PROC.OVRD_COINS

    If OVRD_COINS is not NULL then OVRD_COINS Otherwise COINSURANCE

    Received Claim ICD Procedure Load
    CoinsuranceAmount

    NULL

    Received Claim Procedure Load
    CoinsuranceAmount
    AP_CLAIM_PROC.COINSURANCE
    AP_CLAIM_PROC.OVRD_COINS

    If OVRD_COINS is not NULL then OVRD_COINS Otherwise COINSURANCE

    DeductibleAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    DeductibleAmount

    NULL

    CMS ACO Part A Procedure Files Load
    DeductibleAmount

    NULL

    CMS ACO Part B DME File Load
    DeductibleAmount

    NULL

    CMS ACO Part B Physicians File Load
    DeductibleAmount

    NULL

    CMS CJR DME Claim Procedure Load
    DeductibleAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    DeductibleAmount

    NULL

    CMS CJR Inpatient Claim Procedure Load
    DeductibleAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    DeductibleAmount

    NULL

    CMS CJR Part B Claim Procedure Load
    DeductibleAmount

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    DeductibleAmount

    NULL

    CMS CJR Surgical Procedure Load
    DeductibleAmount

    NULL

    Data Aggregation ICD Procedure Load
    DeductibleAmount

    NULL

    Data Aggregation Service Line Load
    DeductibleAmount
    AP_CLAIM_PROC.DEDUCTIBLE
    AP_CLAIM_PROC.OVRD_DEDUCTIBLE

    If OVRD_DEDUCTIBLE is not NULL then OVRD_DEDUCTIBLE Otherwise DEDUCTIBLE

    Externally Adjudicated ICD Procedure Load
    DeductibleAmount

    NULL

    Externally Adjudicated Service Line Load
    DeductibleAmount
    AP_CLAIM_PROC.DEDUCTIBLE
    AP_CLAIM_PROC.OVRD_DEDUCTIBLE

    If OVRD_DEDUCTIBLE is not NULL then OVRD_DEDUCTIBLE Otherwise DEDUCTIBLE

    Payer System ICD Procedure Load
    DeductibleAmount

    NULL

    Payer System Service Line Load
    DeductibleAmount
    AP_CLAIM_PROC.DEDUCTIBLE
    AP_CLAIM_PROC.OVRD_DEDUCTIBLE

    If OVRD_DEDUCTIBLE is not NULL then OVRD_DEDUCTIBLE Otherwise DEDUCTIBLE

    Received Claim ICD Procedure Load
    DeductibleAmount

    NULL

    Received Claim Procedure Load
    DeductibleAmount
    AP_CLAIM_PROC.DEDUCTIBLE
    AP_CLAIM_PROC.OVRD_DEDUCTIBLE

    If OVRD_DEDUCTIBLE is not NULL then OVRD_DEDUCTIBLE Otherwise DEDUCTIBLE

    NotCoveredAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    NotCoveredAmount

    NULL

    CMS ACO Part A Procedure Files Load
    NotCoveredAmount

    NULL

    CMS ACO Part B DME File Load
    NotCoveredAmount

    NULL

    CMS ACO Part B Physicians File Load
    NotCoveredAmount

    NULL

    CMS CJR DME Claim Procedure Load
    NotCoveredAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    NotCoveredAmount

    NULL

    CMS CJR Inpatient Claim Procedure Load
    NotCoveredAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    NotCoveredAmount

    NULL

    CMS CJR Part B Claim Procedure Load
    NotCoveredAmount

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    NotCoveredAmount

    NULL

    CMS CJR Surgical Procedure Load
    NotCoveredAmount

    NULL

    Data Aggregation ICD Procedure Load
    NotCoveredAmount

    NULL

    Data Aggregation Service Line Load
    NotCoveredAmount
    AP_CLAIM_PROC.NON_CVD_AMT
    AP_CLAIM_PROC.OVRD_NOT_CVD

    If OVRD_NOT_CVD is not NULL then OVRD_NOT_CVD Otherwise NON_CVD_AMT

    Externally Adjudicated ICD Procedure Load
    NotCoveredAmount

    NULL

    Externally Adjudicated Service Line Load
    NotCoveredAmount
    AP_CLAIM_PROC.NON_CVD_AMT
    AP_CLAIM_PROC.OVRD_NOT_CVD

    If OVRD_NOT_CVD is not NULL then OVRD_NOT_CVD Otherwise NON_CVD_AMT

    Payer System ICD Procedure Load
    NotCoveredAmount

    NULL

    Payer System Service Line Load
    NotCoveredAmount
    AP_CLAIM_PROC.NON_CVD_AMT
    AP_CLAIM_PROC.OVRD_NOT_CVD

    If OVRD_NOT_CVD is not NULL then OVRD_NOT_CVD Otherwise NON_CVD_AMT

    Received Claim ICD Procedure Load
    NotCoveredAmount

    NULL

    Received Claim Procedure Load
    NotCoveredAmount
    AP_CLAIM_PROC.NON_CVD_AMT
    AP_CLAIM_PROC.OVRD_NOT_CVD

    If OVRD_NOT_CVD is not NULL then OVRD_NOT_CVD Otherwise NON_CVD_AMT

    PatientPortionAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PatientPortionAmount

    NULL

    CMS ACO Part A Procedure Files Load
    PatientPortionAmount

    NULL

    CMS ACO Part B DME File Load
    PatientPortionAmount

    NULL

    CMS ACO Part B Physicians File Load
    PatientPortionAmount

    NULL

    CMS CJR DME Claim Procedure Load
    PatientPortionAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    PatientPortionAmount

    NULL

    CMS CJR Inpatient Claim Procedure Load
    PatientPortionAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    PatientPortionAmount
    CmsCjrOutpatientDetail.PTNRSP
    CMS CJR Part B Claim Procedure Load
    PatientPortionAmount

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    PatientPortionAmount

    NULL

    CMS CJR Surgical Procedure Load
    PatientPortionAmount

    NULL

    Data Aggregation ICD Procedure Load
    PatientPortionAmount

    NULL

    Data Aggregation Service Line Load
    PatientPortionAmount
    AP_CLAIM_PROC.OVRD_PAT_PORT
    AP_CLAIM_PROC.PAT_PORTION

    If OVRD_PAT_PORT is not NULL then OVRD_PAT_PORT Otherwise PAT_PORTION

    Externally Adjudicated ICD Procedure Load
    PatientPortionAmount

    NULL

    Externally Adjudicated Service Line Load
    PatientPortionAmount
    AP_CLAIM_PROC.OVRD_PAT_PORT
    AP_CLAIM_PROC.PAT_PORTION

    If OVRD_PAT_PORT is not NULL then OVRD_PAT_PORT Otherwise PAT_PORTION

    Payer System ICD Procedure Load
    PatientPortionAmount

    NULL

    Payer System Service Line Load
    PatientPortionAmount
    AP_CLAIM_PROC.OVRD_PAT_PORT
    AP_CLAIM_PROC.PAT_PORTION

    If OVRD_PAT_PORT is not NULL then OVRD_PAT_PORT Otherwise PAT_PORTION

    Received Claim ICD Procedure Load
    PatientPortionAmount

    NULL

    Received Claim Procedure Load
    PatientPortionAmount
    AP_CLAIM_PROC.OVRD_PAT_PORT
    AP_CLAIM_PROC.PAT_PORTION

    If OVRD_PAT_PORT is not NULL then OVRD_PAT_PORT Otherwise PAT_PORTION

    InsuranceAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    InsuranceAmount

    NULL

    CMS ACO Part A Procedure Files Load
    InsuranceAmount

    NULL

    CMS ACO Part B DME File Load
    InsuranceAmount

    NULL

    CMS ACO Part B Physicians File Load
    InsuranceAmount

    NULL

    CMS CJR DME Claim Procedure Load
    InsuranceAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    InsuranceAmount

    NULL

    CMS CJR Inpatient Claim Procedure Load
    InsuranceAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    InsuranceAmount

    NULL

    CMS CJR Part B Claim Procedure Load
    InsuranceAmount

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    InsuranceAmount

    NULL

    CMS CJR Surgical Procedure Load
    InsuranceAmount

    NULL

    Data Aggregation ICD Procedure Load
    InsuranceAmount

    NULL

    Data Aggregation Service Line Load
    InsuranceAmount
    AP_CLAIM_PROC.PROC_INSURANCE_AMT
    Externally Adjudicated ICD Procedure Load
    InsuranceAmount

    NULL

    Externally Adjudicated Service Line Load
    InsuranceAmount
    AP_CLAIM_PROC.PROC_INSURANCE_AMT
    Payer System ICD Procedure Load
    InsuranceAmount

    NULL

    Payer System Service Line Load
    InsuranceAmount
    AP_CLAIM_PROC.PROC_INSURANCE_AMT
    Received Claim ICD Procedure Load
    InsuranceAmount

    NULL

    Received Claim Procedure Load
    InsuranceAmount
    AP_CLAIM_PROC.PROC_INSURANCE_AMT

    AdjustmentAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    AdjustmentAmount

    NULL

    CMS ACO Part A Procedure Files Load
    AdjustmentAmount

    NULL

    CMS ACO Part B DME File Load
    AdjustmentAmount

    NULL

    CMS ACO Part B Physicians File Load
    AdjustmentAmount

    NULL

    CMS CJR DME Claim Procedure Load
    AdjustmentAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    AdjustmentAmount

    NULL

    CMS CJR Inpatient Claim Procedure Load
    AdjustmentAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    AdjustmentAmount

    NULL

    CMS CJR Part B Claim Procedure Load
    AdjustmentAmount

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    AdjustmentAmount

    NULL

    CMS CJR Surgical Procedure Load
    AdjustmentAmount

    NULL

    Data Aggregation ICD Procedure Load
    AdjustmentAmount

    NULL

    Data Aggregation Service Line Load
    AdjustmentAmount
    AP_CLAIM_PROC.ACTUAL_ADJUSTMENT
    AP_CLAIM_PROC.COMP_ADJUSTMENT

    If ACTUAL_ADJUSTMENT is not NULL then ACTUAL_ADJUSTMENT Otherwise COMP_ADJUSTMENT

    Externally Adjudicated ICD Procedure Load
    AdjustmentAmount

    NULL

    Externally Adjudicated Service Line Load
    AdjustmentAmount
    AP_CLAIM_PROC.ACTUAL_ADJUSTMENT
    AP_CLAIM_PROC.COMP_ADJUSTMENT

    If ACTUAL_ADJUSTMENT is not NULL then ACTUAL_ADJUSTMENT Otherwise COMP_ADJUSTMENT

    Payer System ICD Procedure Load
    AdjustmentAmount

    NULL

    Payer System Service Line Load
    AdjustmentAmount
    AP_CLAIM_PROC.ACTUAL_ADJUSTMENT
    AP_CLAIM_PROC.COMP_ADJUSTMENT

    If ACTUAL_ADJUSTMENT is not NULL then ACTUAL_ADJUSTMENT Otherwise COMP_ADJUSTMENT

    Received Claim ICD Procedure Load
    AdjustmentAmount

    NULL

    Received Claim Procedure Load
    AdjustmentAmount
    AP_CLAIM_PROC.ACTUAL_ADJUSTMENT
    AP_CLAIM_PROC.COMP_ADJUSTMENT

    If ACTUAL_ADJUSTMENT is not NULL then ACTUAL_ADJUSTMENT Otherwise COMP_ADJUSTMENT

    NetInsuranceAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    NetInsuranceAmount

    NULL

    CMS ACO Part A Procedure Files Load
    NetInsuranceAmount

    NULL

    CMS ACO Part B DME File Load
    NetInsuranceAmount

    NULL

    CMS ACO Part B Physicians File Load
    NetInsuranceAmount

    NULL

    CMS CJR DME Claim Procedure Load
    NetInsuranceAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    NetInsuranceAmount

    NULL

    CMS CJR Inpatient Claim Procedure Load
    NetInsuranceAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    NetInsuranceAmount

    NULL

    CMS CJR Part B Claim Procedure Load
    NetInsuranceAmount

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    NetInsuranceAmount

    NULL

    CMS CJR Surgical Procedure Load
    NetInsuranceAmount

    NULL

    Data Aggregation ICD Procedure Load
    NetInsuranceAmount

    NULL

    Data Aggregation Service Line Load
    NetInsuranceAmount
    AP_CLAIM_PROC.NET_INSURANCE_AMT
    Externally Adjudicated ICD Procedure Load
    NetInsuranceAmount

    NULL

    Externally Adjudicated Service Line Load
    NetInsuranceAmount
    AP_CLAIM_PROC.NET_INSURANCE_AMT
    Payer System ICD Procedure Load
    NetInsuranceAmount

    NULL

    Payer System Service Line Load
    NetInsuranceAmount
    AP_CLAIM_PROC.NET_INSURANCE_AMT
    Received Claim ICD Procedure Load
    NetInsuranceAmount

    NULL

    Received Claim Procedure Load
    NetInsuranceAmount
    AP_CLAIM_PROC.NET_INSURANCE_AMT

    ExceededBenefitAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ExceededBenefitAmount

    NULL

    CMS ACO Part A Procedure Files Load
    ExceededBenefitAmount

    NULL

    CMS ACO Part B DME File Load
    ExceededBenefitAmount

    NULL

    CMS ACO Part B Physicians File Load
    ExceededBenefitAmount

    NULL

    CMS CJR DME Claim Procedure Load
    ExceededBenefitAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    ExceededBenefitAmount

    NULL

    CMS CJR Inpatient Claim Procedure Load
    ExceededBenefitAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    ExceededBenefitAmount

    NULL

    CMS CJR Part B Claim Procedure Load
    ExceededBenefitAmount

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    ExceededBenefitAmount

    NULL

    CMS CJR Surgical Procedure Load
    ExceededBenefitAmount

    NULL

    Data Aggregation ICD Procedure Load
    ExceededBenefitAmount

    NULL

    Data Aggregation Service Line Load
    ExceededBenefitAmount
    AP_CLAIM_PROC.EXCEEDED_BEN_AMT
    AP_CLAIM_PROC.OVRD_EXCD_BEN_AMT

    If OVRD_EXCD_BEN_AMT is not NULL then OVRD_EXCD_BEN_AMT Otherwise EXCEEDED_BEN_AMT

    Externally Adjudicated ICD Procedure Load
    ExceededBenefitAmount

    NULL

    Externally Adjudicated Service Line Load
    ExceededBenefitAmount
    AP_CLAIM_PROC.EXCEEDED_BEN_AMT
    AP_CLAIM_PROC.OVRD_EXCD_BEN_AMT

    If OVRD_EXCD_BEN_AMT is not NULL then OVRD_EXCD_BEN_AMT Otherwise EXCEEDED_BEN_AMT

    Payer System ICD Procedure Load
    ExceededBenefitAmount

    NULL

    Payer System Service Line Load
    ExceededBenefitAmount
    AP_CLAIM_PROC.EXCEEDED_BEN_AMT
    AP_CLAIM_PROC.OVRD_EXCD_BEN_AMT

    If OVRD_EXCD_BEN_AMT is not NULL then OVRD_EXCD_BEN_AMT Otherwise EXCEEDED_BEN_AMT

    Received Claim ICD Procedure Load
    ExceededBenefitAmount

    NULL

    Received Claim Procedure Load
    ExceededBenefitAmount
    AP_CLAIM_PROC.EXCEEDED_BEN_AMT
    AP_CLAIM_PROC.OVRD_EXCD_BEN_AMT

    If OVRD_EXCD_BEN_AMT is not NULL then OVRD_EXCD_BEN_AMT Otherwise EXCEEDED_BEN_AMT

    WithholdingAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    WithholdingAmount

    NULL

    CMS ACO Part A Procedure Files Load
    WithholdingAmount

    NULL

    CMS ACO Part B DME File Load
    WithholdingAmount

    NULL

    CMS ACO Part B Physicians File Load
    WithholdingAmount

    NULL

    CMS CJR DME Claim Procedure Load
    WithholdingAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    WithholdingAmount

    NULL

    CMS CJR Inpatient Claim Procedure Load
    WithholdingAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    WithholdingAmount

    NULL

    CMS CJR Part B Claim Procedure Load
    WithholdingAmount

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    WithholdingAmount

    NULL

    CMS CJR Surgical Procedure Load
    WithholdingAmount

    NULL

    Data Aggregation ICD Procedure Load
    WithholdingAmount

    NULL

    Data Aggregation Service Line Load
    WithholdingAmount
    AP_CLAIM_PROC.COMP_WITHHOLDING
    AP_CLAIM_PROC.WITHHOLDING

    If WITHHOLDING is not NULL then WITHHOLDING Otherwise COMP_WITHHOLDING

    Externally Adjudicated ICD Procedure Load
    WithholdingAmount

    NULL

    Externally Adjudicated Service Line Load
    WithholdingAmount
    AP_CLAIM_PROC.COMP_WITHHOLDING
    AP_CLAIM_PROC.WITHHOLDING

    If WITHHOLDING is not NULL then WITHHOLDING Otherwise COMP_WITHHOLDING

    Payer System ICD Procedure Load
    WithholdingAmount

    NULL

    Payer System Service Line Load
    WithholdingAmount
    AP_CLAIM_PROC.COMP_WITHHOLDING
    AP_CLAIM_PROC.WITHHOLDING

    If WITHHOLDING is not NULL then WITHHOLDING Otherwise COMP_WITHHOLDING

    Received Claim ICD Procedure Load
    WithholdingAmount

    NULL

    Received Claim Procedure Load
    WithholdingAmount
    AP_CLAIM_PROC.COMP_WITHHOLDING
    AP_CLAIM_PROC.WITHHOLDING

    If WITHHOLDING is not NULL then WITHHOLDING Otherwise COMP_WITHHOLDING

    NetPayableAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    NetPayableAmount
    MsspPartAClaimsDetail.CLM_LINE_CVRD_PD_AMT
    MsspPartAClaimsHeader.CLM_ADJSMT_TYPE_CD

    If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_CVRD_PD_AMT × (-1) Otherwise CLM_LINE_CVRD_PD_AMT

    CMS ACO Part A Procedure Files Load
    NetPayableAmount

    NULL

    CMS ACO Part B DME File Load
    NetPayableAmount
    MsspPartBDme.CLM_ADJSMT_TYPE_CD
    MsspPartBDme.CLM_LINE_CVRD_PD_AMT

    If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_CVRD_PD_AMT × (-1) Otherwise CLM_LINE_CVRD_PD_AMT

    CMS ACO Part B Physicians File Load
    NetPayableAmount
    MsspPartBPhysicians.CLM_ADJSMT_TYPE_CD
    MsspPartBPhysicians.CLM_LINE_CVRD_PD_AMT

    If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_CVRD_PD_AMT × (-1) Otherwise CLM_LINE_CVRD_PD_AMT

    CMS CJR DME Claim Procedure Load
    NetPayableAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    NetPayableAmount
    CmsCjrHomeHealthDetail.REVPMT
    CMS CJR Inpatient Claim Procedure Load
    NetPayableAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    NetPayableAmount
    CmsCjrOutpatientDetail.REVPMT
    CMS CJR Part B Claim Procedure Load
    NetPayableAmount
    CmsCjrPartBDetail.CLM_LINE_CVRD_PD_AMT
    CMS CJR Skilled Nursing Claim Procedure Load
    NetPayableAmount

    NULL

    CMS CJR Surgical Procedure Load
    NetPayableAmount

    NULL

    Data Aggregation ICD Procedure Load
    NetPayableAmount

    NULL

    Data Aggregation Service Line Load
    NetPayableAmount
    AP_CLAIM_PROC.NET_PAYABLE
    Externally Adjudicated ICD Procedure Load
    NetPayableAmount

    NULL

    Externally Adjudicated Service Line Load
    NetPayableAmount
    AP_CLAIM_PROC.NET_PAYABLE
    Payer System ICD Procedure Load
    NetPayableAmount

    NULL

    Payer System Service Line Load
    NetPayableAmount
    AP_CLAIM_PROC.NET_PAYABLE
    Received Claim ICD Procedure Load
    NetPayableAmount

    NULL

    Received Claim Procedure Load
    NetPayableAmount
    AP_CLAIM_PROC.NET_PAYABLE

    InterestAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    InterestAmount

    NULL

    CMS ACO Part A Procedure Files Load
    InterestAmount

    NULL

    CMS ACO Part B DME File Load
    InterestAmount

    NULL

    CMS ACO Part B Physicians File Load
    InterestAmount

    NULL

    CMS CJR DME Claim Procedure Load
    InterestAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    InterestAmount

    NULL

    CMS CJR Inpatient Claim Procedure Load
    InterestAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    InterestAmount

    NULL

    CMS CJR Part B Claim Procedure Load
    InterestAmount

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    InterestAmount

    NULL

    CMS CJR Surgical Procedure Load
    InterestAmount

    NULL

    Data Aggregation ICD Procedure Load
    InterestAmount

    NULL

    Data Aggregation Service Line Load
    InterestAmount
    AP_CLAIM_PROC_3.INTEREST_AMT
    AP_CLAIM_PROC_3.INTEREST_AMT_OVRD

    If INTEREST_AMT_OVRD is not NULL then INTEREST_AMT_OVRD Otherwise INTEREST_AMT

    Externally Adjudicated ICD Procedure Load
    InterestAmount

    NULL

    Externally Adjudicated Service Line Load
    InterestAmount
    AP_CLAIM_PROC_3.INTEREST_AMT
    AP_CLAIM_PROC_3.INTEREST_AMT_OVRD

    If INTEREST_AMT_OVRD is not NULL then INTEREST_AMT_OVRD Otherwise INTEREST_AMT

    Payer System ICD Procedure Load
    InterestAmount

    NULL

    Payer System Service Line Load
    InterestAmount
    AP_CLAIM_PROC_3.INTEREST_AMT
    AP_CLAIM_PROC_3.INTEREST_AMT_OVRD

    If INTEREST_AMT_OVRD is not NULL then INTEREST_AMT_OVRD Otherwise INTEREST_AMT

    Received Claim ICD Procedure Load
    InterestAmount

    NULL

    Received Claim Procedure Load
    InterestAmount
    AP_CLAIM_PROC_3.INTEREST_AMT
    AP_CLAIM_PROC_3.INTEREST_AMT_OVRD

    If INTEREST_AMT_OVRD is not NULL then INTEREST_AMT_OVRD Otherwise INTEREST_AMT

    PenaltyAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    PenaltyAmount

    NULL

    CMS ACO Part A Procedure Files Load
    PenaltyAmount

    NULL

    CMS ACO Part B DME File Load
    PenaltyAmount

    NULL

    CMS ACO Part B Physicians File Load
    PenaltyAmount

    NULL

    CMS CJR DME Claim Procedure Load
    PenaltyAmount
    CMS CJR Home Health Claim Procedure Load
    PenaltyAmount
    CMS CJR Inpatient Claim Procedure Load
    PenaltyAmount
    CMS CJR Outpatient Claim Procedure Load
    PenaltyAmount
    CMS CJR Part B Claim Procedure Load
    PenaltyAmount
    CMS CJR Skilled Nursing Claim Procedure Load
    PenaltyAmount
    CMS CJR Surgical Procedure Load
    PenaltyAmount
    Data Aggregation ICD Procedure Load
    PenaltyAmount

    NULL

    Data Aggregation Service Line Load
    PenaltyAmount
    AP_CLAIM_PROC_3.PENALTY_AMT
    AP_CLAIM_PROC_3.PENALTY_AMT_OVRD

    If AP_CLAIM_PROC_3.PENALTY_AMT_OVRD is not null then AP_CLAIM_PROC_3.PENALTY_AMT_OVRD Otherwise AP_CLAIM_PROC_3.PENALTY_AMT

    Externally Adjudicated ICD Procedure Load
    PenaltyAmount

    NULL

    Externally Adjudicated Service Line Load
    PenaltyAmount
    AP_CLAIM_PROC_3.PENALTY_AMT
    AP_CLAIM_PROC_3.PENALTY_AMT_OVRD

    If AP_CLAIM_PROC_3.PENALTY_AMT_OVRD is not null then AP_CLAIM_PROC_3.PENALTY_AMT_OVRD Otherwise AP_CLAIM_PROC_3.PENALTY_AMT

    Payer System ICD Procedure Load
    PenaltyAmount

    NULL

    Payer System Service Line Load
    PenaltyAmount
    AP_CLAIM_PROC_3.PENALTY_AMT
    AP_CLAIM_PROC_3.PENALTY_AMT_OVRD

    If AP_CLAIM_PROC_3.PENALTY_AMT_OVRD is not null then AP_CLAIM_PROC_3.PENALTY_AMT_OVRD Otherwise AP_CLAIM_PROC_3.PENALTY_AMT

    Received Claim ICD Procedure Load
    PenaltyAmount

    NULL

    Received Claim Procedure Load
    PenaltyAmount
    AP_CLAIM_PROC_3.PENALTY_AMT
    AP_CLAIM_PROC_3.PENALTY_AMT_OVRD

    If AP_CLAIM_PROC_3.PENALTY_AMT_OVRD is not null then AP_CLAIM_PROC_3.PENALTY_AMT_OVRD Otherwise AP_CLAIM_PROC_3.PENALTY_AMT

    CobPrimaryInsuranceAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    CobPrimaryInsuranceAmount

    NULL

    CMS ACO Part A Procedure Files Load
    CobPrimaryInsuranceAmount

    NULL

    CMS ACO Part B DME File Load
    CobPrimaryInsuranceAmount

    NULL

    CMS ACO Part B Physicians File Load
    CobPrimaryInsuranceAmount

    NULL

    CMS CJR DME Claim Procedure Load
    CobPrimaryInsuranceAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    CobPrimaryInsuranceAmount

    NULL

    CMS CJR Inpatient Claim Procedure Load
    CobPrimaryInsuranceAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    CobPrimaryInsuranceAmount

    NULL

    CMS CJR Part B Claim Procedure Load
    CobPrimaryInsuranceAmount

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    CobPrimaryInsuranceAmount

    NULL

    CMS CJR Surgical Procedure Load
    CobPrimaryInsuranceAmount

    NULL

    Data Aggregation ICD Procedure Load
    CobPrimaryInsuranceAmount

    NULL

    Data Aggregation Service Line Load
    CobPrimaryInsuranceAmount
    AP_CLAIM_PROC.PRIM_INS_AMOUNT
    Externally Adjudicated ICD Procedure Load
    CobPrimaryInsuranceAmount

    NULL

    Externally Adjudicated Service Line Load
    CobPrimaryInsuranceAmount
    AP_CLAIM_PROC.PRIM_INS_AMOUNT
    Payer System ICD Procedure Load
    CobPrimaryInsuranceAmount

    NULL

    Payer System Service Line Load
    CobPrimaryInsuranceAmount
    AP_CLAIM_PROC.PRIM_INS_AMOUNT
    Received Claim ICD Procedure Load
    CobPrimaryInsuranceAmount

    NULL

    Received Claim Procedure Load
    CobPrimaryInsuranceAmount
    AP_CLAIM_PROC.PRIM_INS_AMOUNT

    CobPrimaryInsurancePatientPortionAmount

    : number

    Properties

    Data type
    number
    SQL Server data type
    numeric(18,2)
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    CobPrimaryInsurancePatientPortionAmount

    NULL

    CMS ACO Part A Procedure Files Load
    CobPrimaryInsurancePatientPortionAmount

    NULL

    CMS ACO Part B DME File Load
    CobPrimaryInsurancePatientPortionAmount

    NULL

    CMS ACO Part B Physicians File Load
    CobPrimaryInsurancePatientPortionAmount

    NULL

    CMS CJR DME Claim Procedure Load
    CobPrimaryInsurancePatientPortionAmount

    NULL

    CMS CJR Home Health Claim Procedure Load
    CobPrimaryInsurancePatientPortionAmount

    NULL

    CMS CJR Inpatient Claim Procedure Load
    CobPrimaryInsurancePatientPortionAmount

    NULL

    CMS CJR Outpatient Claim Procedure Load
    CobPrimaryInsurancePatientPortionAmount

    NULL

    CMS CJR Part B Claim Procedure Load
    CobPrimaryInsurancePatientPortionAmount

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    CobPrimaryInsurancePatientPortionAmount

    NULL

    CMS CJR Surgical Procedure Load
    CobPrimaryInsurancePatientPortionAmount

    NULL

    Data Aggregation ICD Procedure Load
    CobPrimaryInsurancePatientPortionAmount

    NULL

    Data Aggregation Service Line Load
    CobPrimaryInsurancePatientPortionAmount
    AP_CLAIM_PROC.PRIM_PAT_PORTION
    Externally Adjudicated ICD Procedure Load
    CobPrimaryInsurancePatientPortionAmount

    NULL

    Externally Adjudicated Service Line Load
    CobPrimaryInsurancePatientPortionAmount
    AP_CLAIM_PROC.PRIM_PAT_PORTION
    Payer System ICD Procedure Load
    CobPrimaryInsurancePatientPortionAmount

    NULL

    Payer System Service Line Load
    CobPrimaryInsurancePatientPortionAmount
    AP_CLAIM_PROC.PRIM_PAT_PORTION
    Received Claim ICD Procedure Load
    CobPrimaryInsurancePatientPortionAmount

    NULL

    Received Claim Procedure Load
    CobPrimaryInsurancePatientPortionAmount
    AP_CLAIM_PROC.PRIM_PAT_PORTION

    ExternalClaim

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    ExternalClaim

    NULL

    CMS ACO Part A Procedure Files Load
    ExternalClaim

    NULL

    CMS ACO Part B DME File Load
    ExternalClaim

    NULL

    CMS ACO Part B Physicians File Load
    ExternalClaim

    NULL

    CMS CJR DME Claim Procedure Load
    ExternalClaim

    NULL

    CMS CJR Home Health Claim Procedure Load
    ExternalClaim

    NULL

    CMS CJR Inpatient Claim Procedure Load
    ExternalClaim

    NULL

    CMS CJR Outpatient Claim Procedure Load
    ExternalClaim

    NULL

    CMS CJR Part B Claim Procedure Load
    ExternalClaim

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    ExternalClaim

    NULL

    CMS CJR Surgical Procedure Load
    ExternalClaim

    NULL

    Data Aggregation ICD Procedure Load
    ExternalClaim

    NULL

    Data Aggregation Service Line Load
    ExternalClaim

    NULL

    Externally Adjudicated ICD Procedure Load
    ExternalClaim

    NULL

    Externally Adjudicated Service Line Load
    ExternalClaim

    NULL

    Payer System ICD Procedure Load
    ExternalClaim

    NULL

    Payer System Service Line Load
    ExternalClaim

    NULL

    Received Claim ICD Procedure Load
    ExternalClaim

    NULL

    Received Claim Procedure Load
    ExternalClaim

    NULL

    IsCurrentInClaimProcedureSequence

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsCurrentInClaimProcedureSequence

    NULL

    CMS ACO Part A Procedure Files Load
    IsCurrentInClaimProcedureSequence

    NULL

    CMS ACO Part B DME File Load
    IsCurrentInClaimProcedureSequence

    NULL

    CMS ACO Part B Physicians File Load
    IsCurrentInClaimProcedureSequence

    NULL

    CMS CJR DME Claim Procedure Load
    IsCurrentInClaimProcedureSequence

    NULL

    CMS CJR Home Health Claim Procedure Load
    IsCurrentInClaimProcedureSequence

    NULL

    CMS CJR Inpatient Claim Procedure Load
    IsCurrentInClaimProcedureSequence

    NULL

    CMS CJR Outpatient Claim Procedure Load
    IsCurrentInClaimProcedureSequence

    NULL

    CMS CJR Part B Claim Procedure Load
    IsCurrentInClaimProcedureSequence

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    IsCurrentInClaimProcedureSequence

    NULL

    CMS CJR Surgical Procedure Load
    IsCurrentInClaimProcedureSequence

    NULL

    Data Aggregation ICD Procedure Load
    IsCurrentInClaimProcedureSequence

    NULL

    Data Aggregation Service Line Load
    IsCurrentInClaimProcedureSequence

    NULL

    Externally Adjudicated ICD Procedure Load
    IsCurrentInClaimProcedureSequence

    NULL

    Externally Adjudicated Service Line Load
    IsCurrentInClaimProcedureSequence

    NULL

    Payer System ICD Procedure Load
    IsCurrentInClaimProcedureSequence

    NULL

    Payer System Service Line Load
    IsCurrentInClaimProcedureSequence

    NULL

    Received Claim ICD Procedure Load
    IsCurrentInClaimProcedureSequence

    NULL

    Received Claim Procedure Load
    IsCurrentInClaimProcedureSequence

    NULL

    IsFirstServiceLevelProcedure

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsFirstServiceLevelProcedure

    NULL

    CMS ACO Part A Procedure Files Load
    IsFirstServiceLevelProcedure

    NULL

    CMS ACO Part B DME File Load
    IsFirstServiceLevelProcedure

    NULL

    CMS ACO Part B Physicians File Load
    IsFirstServiceLevelProcedure

    NULL

    CMS CJR DME Claim Procedure Load
    IsFirstServiceLevelProcedure

    NULL

    CMS CJR Home Health Claim Procedure Load
    IsFirstServiceLevelProcedure

    NULL

    CMS CJR Inpatient Claim Procedure Load
    IsFirstServiceLevelProcedure

    NULL

    CMS CJR Outpatient Claim Procedure Load
    IsFirstServiceLevelProcedure

    NULL

    CMS CJR Part B Claim Procedure Load
    IsFirstServiceLevelProcedure

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    IsFirstServiceLevelProcedure

    NULL

    CMS CJR Surgical Procedure Load
    IsFirstServiceLevelProcedure

    NULL

    Data Aggregation ICD Procedure Load
    IsFirstServiceLevelProcedure

    NULL

    Data Aggregation Service Line Load
    IsFirstServiceLevelProcedure

    NULL

    Externally Adjudicated ICD Procedure Load
    IsFirstServiceLevelProcedure

    NULL

    Externally Adjudicated Service Line Load
    IsFirstServiceLevelProcedure
    AP_CLAIM_PROC.TX_TYPE_C
    AP_CLAIM_PROC_IDS.LINE

    If LINE = 1 and no rows exist where TX_TYPE_C = 6 then 1 Otherwise if LINE = 2 and at least one row exists where TX_TYPE_C = 6 then 1 Otherwise 0

    Payer System ICD Procedure Load
    IsFirstServiceLevelProcedure

    NULL

    Payer System Service Line Load
    IsFirstServiceLevelProcedure

    NULL

    Received Claim ICD Procedure Load
    IsFirstServiceLevelProcedure

    NULL

    Received Claim Procedure Load
    IsFirstServiceLevelProcedure
    AP_CLAIM_PROC.TX_TYPE_C
    AP_CLAIM_PROC_IDS.LINE

    If LINE = 1 and no rows exist where TX_TYPE_C = 6 then 1 Otherwise if LINE = 2 and at least one row exists where TX_TYPE_C = 6 then 1 Otherwise 0

    IsValidClaimProcedureSequence

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
    Default value
    1
    Delete value
    0

    IsCapitated

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsCapitated

    NULL

    CMS ACO Part A Procedure Files Load
    IsCapitated

    NULL

    CMS ACO Part B DME File Load
    IsCapitated

    NULL

    CMS ACO Part B Physicians File Load
    IsCapitated

    NULL

    CMS CJR DME Claim Procedure Load
    IsCapitated

    NULL

    CMS CJR Home Health Claim Procedure Load
    IsCapitated

    NULL

    CMS CJR Inpatient Claim Procedure Load
    IsCapitated

    NULL

    CMS CJR Outpatient Claim Procedure Load
    IsCapitated

    NULL

    CMS CJR Part B Claim Procedure Load
    IsCapitated

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    IsCapitated

    NULL

    CMS CJR Surgical Procedure Load
    IsCapitated

    NULL

    Data Aggregation ICD Procedure Load
    IsCapitated

    NULL

    Data Aggregation Service Line Load
    IsCapitated
    AP_CLAIM_PROC_3.SYS_ADJUST_REASON_C

    If SYS_ADJUST_REASON_C = 1 - Procedure is capitated then 1 Otherwise 0

    Externally Adjudicated ICD Procedure Load
    IsCapitated

    NULL

    Externally Adjudicated Service Line Load
    IsCapitated

    0

    Payer System ICD Procedure Load
    IsCapitated

    NULL

    Payer System Service Line Load
    IsCapitated
    AP_CLAIM_PROC_3.SYS_ADJUST_REASON_C

    If SYS_ADJUST_REASON_C = 1 - Procedure is capitated then 1 Otherwise 0

    Received Claim ICD Procedure Load
    IsCapitated

    NULL

    Received Claim Procedure Load
    IsCapitated
    AP_CLAIM_PROC_3.SYS_ADJUST_REASON_C

    If SYS_ADJUST_REASON_C = 1 - Procedure is capitated then 1 Otherwise 0

    IsClinicallyValid

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsClinicallyValid
    MsspPartAClaimsHeader.BENE_EQTBL_BIC_HICN_NUM
    MsspPartAClaimsHeader.CLM_ADJSMT_TYPE_CD
    MsspPartAClaimsHeader.CLM_EFCTV_DT
    MsspPartAClaimsHeader.CLM_FROM_DT
    MsspPartAClaimsHeader.CLM_THRU_DT
    MsspPartAClaimsHeader.PRVDR_OSCAR_NUM

    If the claim is the last claim in the sequence among claims with CLM_ADJSMT_TYPE_CD ≠1-Cancelation Claim and with the same PRVDR_OSCAR_NUM, CLM_FROM_DT, CLM_THRU_DT, and BENE_EQTBL_BIC_HICN_NUM then "1", otherwise "0"

    CMS ACO Part A Procedure Files Load
    IsClinicallyValid
    MsspPartAClaimsHeader.BENE_EQTBL_BIC_HICN_NUM
    MsspPartAClaimsHeader.CLM_ADJSMT_TYPE_CD
    MsspPartAClaimsHeader.CLM_EFCTV_DT
    MsspPartAClaimsHeader.CLM_FROM_DT
    MsspPartAClaimsHeader.CLM_THRU_DT
    MsspPartAClaimsHeader.PRVDR_OSCAR_NUM

    If the claim is the last claim in the sequence among claims with CLM_ADJSMT_TYPE_CD ≠1-Cancelation Claim and with the same PRVDR_OSCAR_NUM, CLM_FROM_DT, CLM_THRU_DT, and BENE_EQTBL_BIC_HICN_NUM then "1", otherwise "0"

    CMS ACO Part B DME File Load
    IsClinicallyValid
    MsspPartBDme.BENE_EQTBL_BIC_HICN_NUM
    MsspPartBDme.CLM_ADJSMT_TYPE_CD
    MsspPartBDme.CLM_CNTL_NUM
    MsspPartBDme.CLM_EFCTV_DT

    If the claim is the last claim in the sequence among claims with CLM_ADJSMT_TYPE_CD ≠1-Cancelation Claim and with the same CLM_CNTL_NUM and BENE_EQTBL_BIC_HICN_NUM then "1", otherwise "0"

    CMS ACO Part B Physicians File Load
    IsClinicallyValid
    MsspPartBPhysicians.BENE_EQTBL_BIC_HICN_NUM
    MsspPartBPhysicians.CLM_ADJSMT_TYPE_CD
    MsspPartBPhysicians.CLM_CNTL_NUM
    MsspPartBPhysicians.CLM_EFCTV_DT

    If the claim is the last claim in the sequence among claims with CLM_ADJSMT_TYPE_CD ≠1-Cancelation Claim and with the same CLM_CNTL_NUM and BENE_EQTBL_BIC_HICN_NUM then "1", otherwise "0"

    CMS CJR DME Claim Procedure Load
    IsClinicallyValid

    1

    CMS CJR Home Health Claim Procedure Load
    IsClinicallyValid

    1

    CMS CJR Inpatient Claim Procedure Load
    IsClinicallyValid

    1

    CMS CJR Outpatient Claim Procedure Load
    IsClinicallyValid

    1

    CMS CJR Part B Claim Procedure Load
    IsClinicallyValid

    1

    CMS CJR Skilled Nursing Claim Procedure Load
    IsClinicallyValid

    1

    CMS CJR Surgical Procedure Load
    IsClinicallyValid

    1

    Data Aggregation ICD Procedure Load
    IsClinicallyValid
    AP_CLAIM.ADJST_CLM_ID
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_3.INVALID_YN
    AP_CLAIM_3.IS_CLINICALLY_VALID_YN
    AP_CLAIM_3.OVERRIDE_INVALID_YN

    If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1

    Data Aggregation Service Line Load
    IsClinicallyValid
    AP_CLAIM.ADJST_CLM_ID
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_3.INVALID_YN
    AP_CLAIM_3.IS_CLINICALLY_VALID_YN
    AP_CLAIM_3.OVERRIDE_INVALID_YN

    If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1

    Externally Adjudicated ICD Procedure Load
    IsClinicallyValid
    AP_CLAIM.ADJST_CLM_ID
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_3.INVALID_YN
    AP_CLAIM_3.IS_INVLD_ADJ_SEQ_YN
    AP_CLAIM_3.OVERRIDE_INVALID_YN

    If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if IS_INVLD_ADJ_SEQ_YN = "Y" then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1

    Externally Adjudicated Service Line Load
    IsClinicallyValid
    AP_CLAIM.ADJST_CLM_ID
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_3.INVALID_YN
    AP_CLAIM_3.IS_INVLD_ADJ_SEQ_YN
    AP_CLAIM_3.OVERRIDE_INVALID_YN

    If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if IS_INVLD_ADJ_SEQ_YN = "Y" then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise if IS_INVLD_ADJ_SEQ_YN = "Y" then 0 Otherwise 1

    Payer System ICD Procedure Load
    IsClinicallyValid
    AP_CLAIM.ADJST_CLM_ID
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_3.INVALID_YN
    AP_CLAIM_3.IS_CLINICALLY_VALID_YN
    AP_CLAIM_3.OVERRIDE_INVALID_YN

    If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1

    Payer System Service Line Load
    IsClinicallyValid
    AP_CLAIM.ADJST_CLM_ID
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_3.INVALID_YN
    AP_CLAIM_3.IS_CLINICALLY_VALID_YN
    AP_CLAIM_3.OVERRIDE_INVALID_YN

    If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1

    Received Claim ICD Procedure Load
    IsClinicallyValid
    AP_CLAIM.ADJST_CLM_ID
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_3.INVALID_YN
    AP_CLAIM_3.IS_INVLD_ADJ_SEQ_YN
    AP_CLAIM_3.OVERRIDE_INVALID_YN

    If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if IS_INVLD_ADJ_SEQ_YN = "Y" then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1

    Received Claim Procedure Load
    IsClinicallyValid
    AP_CLAIM.ADJST_CLM_ID
    AP_CLAIM.CLAIM_ID
    AP_CLAIM.ORIG_REV_CLM_ID
    AP_CLAIM_2.CLM_FREQ_CODE_C
    AP_CLAIM_3.INVALID_YN
    AP_CLAIM_3.IS_INVLD_ADJ_SEQ_YN
    AP_CLAIM_3.OVERRIDE_INVALID_YN

    If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if IS_INVLD_ADJ_SEQ_YN = "Y" then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1

    IsHospitalOutpatientVisit

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0
    Delete value
    0

    IsEmergencyDefiningClaimLine

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0
    Delete value
    0

    IsOutpatientDefiningClaimLine

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0
    Delete value
    0

    IsInterpretedClaimDetailTypeFromSourceData

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0
    Delete value
    0
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsInterpretedClaimDetailTypeFromSourceData

    NULL

    CMS ACO Part A Procedure Files Load
    IsInterpretedClaimDetailTypeFromSourceData

    NULL

    CMS ACO Part B DME File Load
    IsInterpretedClaimDetailTypeFromSourceData

    NULL

    CMS ACO Part B Physicians File Load
    IsInterpretedClaimDetailTypeFromSourceData

    NULL

    CMS CJR DME Claim Procedure Load
    IsInterpretedClaimDetailTypeFromSourceData

    NULL

    CMS CJR Home Health Claim Procedure Load
    IsInterpretedClaimDetailTypeFromSourceData

    NULL

    CMS CJR Inpatient Claim Procedure Load
    IsInterpretedClaimDetailTypeFromSourceData

    NULL

    CMS CJR Outpatient Claim Procedure Load
    IsInterpretedClaimDetailTypeFromSourceData

    NULL

    CMS CJR Part B Claim Procedure Load
    IsInterpretedClaimDetailTypeFromSourceData

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    IsInterpretedClaimDetailTypeFromSourceData

    NULL

    CMS CJR Surgical Procedure Load
    IsInterpretedClaimDetailTypeFromSourceData

    NULL

    Externally Adjudicated ICD Procedure Load
    IsInterpretedClaimDetailTypeFromSourceData

    NULL

    Externally Adjudicated Service Line Load
    IsInterpretedClaimDetailTypeFromSourceData

    NULL

    Received Claim ICD Procedure Load
    IsInterpretedClaimDetailTypeFromSourceData

    NULL

    Received Claim Procedure Load
    IsInterpretedClaimDetailTypeFromSourceData

    NULL

    IsNonCclClaim

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    1
    Delete value
    1
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsNonCclClaim
    CMS ACO Part A Procedure Files Load
    IsNonCclClaim
    CMS ACO Part B DME File Load
    IsNonCclClaim
    CMS ACO Part B Physicians File Load
    IsNonCclClaim
    CMS CJR DME Claim Procedure Load
    IsNonCclClaim
    CMS CJR Home Health Claim Procedure Load
    IsNonCclClaim
    CMS CJR Inpatient Claim Procedure Load
    IsNonCclClaim
    CMS CJR Outpatient Claim Procedure Load
    IsNonCclClaim
    CMS CJR Part B Claim Procedure Load
    IsNonCclClaim
    CMS CJR Skilled Nursing Claim Procedure Load
    IsNonCclClaim
    CMS CJR Surgical Procedure Load
    IsNonCclClaim
    Externally Adjudicated ICD Procedure Load
    IsNonCclClaim
    Externally Adjudicated Service Line Load
    IsNonCclClaim
    Received Claim ICD Procedure Load
    IsNonCclClaim
    Received Claim Procedure Load
    IsNonCclClaim

    IsAuthorizationRequired

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    IsAuthorizationRequired

    NULL

    CMS ACO Part A Procedure Files Load
    IsAuthorizationRequired

    NULL

    CMS ACO Part B DME File Load
    IsAuthorizationRequired

    NULL

    CMS ACO Part B Physicians File Load
    IsAuthorizationRequired

    NULL

    CMS CJR DME Claim Procedure Load
    IsAuthorizationRequired

    NULL

    CMS CJR Home Health Claim Procedure Load
    IsAuthorizationRequired

    NULL

    CMS CJR Inpatient Claim Procedure Load
    IsAuthorizationRequired

    NULL

    CMS CJR Outpatient Claim Procedure Load
    IsAuthorizationRequired

    NULL

    CMS CJR Part B Claim Procedure Load
    IsAuthorizationRequired

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    IsAuthorizationRequired

    NULL

    CMS CJR Surgical Procedure Load
    IsAuthorizationRequired

    NULL

    Data Aggregation ICD Procedure Load
    IsAuthorizationRequired

    NULL

    Data Aggregation Service Line Load
    IsAuthorizationRequired

    NULL

    Externally Adjudicated ICD Procedure Load
    IsAuthorizationRequired

    NULL

    Externally Adjudicated Service Line Load
    IsAuthorizationRequired

    NULL

    Payer System ICD Procedure Load
    IsAuthorizationRequired
    Payer System Service Line Load
    IsAuthorizationRequired
    Received Claim ICD Procedure Load
    IsAuthorizationRequired

    NULL

    Received Claim Procedure Load
    IsAuthorizationRequired
    AP_CLAIM_PROC_4.AUTH_REQ_YN

    If AUTH_REQ_YN = "Y" then 1 If AUTH_REQ_YN = "N" then 0 Otherwise NULL

    HasSuggestedAuthorization

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
  • Data Lineage for Each Package

    CMS ACO Part A Files Load
    HasSuggestedAuthorization

    NULL

    CMS ACO Part A Procedure Files Load
    HasSuggestedAuthorization

    NULL

    CMS ACO Part B DME File Load
    HasSuggestedAuthorization

    NULL

    CMS ACO Part B Physicians File Load
    HasSuggestedAuthorization

    NULL

    CMS CJR DME Claim Procedure Load
    HasSuggestedAuthorization

    NULL

    CMS CJR Home Health Claim Procedure Load
    HasSuggestedAuthorization

    NULL

    CMS CJR Inpatient Claim Procedure Load
    HasSuggestedAuthorization

    NULL

    CMS CJR Outpatient Claim Procedure Load
    HasSuggestedAuthorization

    NULL

    CMS CJR Part B Claim Procedure Load
    HasSuggestedAuthorization

    NULL

    CMS CJR Skilled Nursing Claim Procedure Load
    HasSuggestedAuthorization

    NULL

    CMS CJR Surgical Procedure Load
    HasSuggestedAuthorization

    NULL

    Data Aggregation ICD Procedure Load
    HasSuggestedAuthorization

    NULL

    Data Aggregation Service Line Load
    HasSuggestedAuthorization

    NULL

    Externally Adjudicated ICD Procedure Load
    HasSuggestedAuthorization

    NULL

    Externally Adjudicated Service Line Load
    HasSuggestedAuthorization

    NULL

    Payer System ICD Procedure Load
    HasSuggestedAuthorization
    Payer System Service Line Load
    HasSuggestedAuthorization
    Received Claim ICD Procedure Load
    HasSuggestedAuthorization

    NULL

    Received Claim Procedure Load
    HasSuggestedAuthorization
    AP_CLAIM_PROC_4.SUGGESTED_AUTH_FOUND_YN

    If POTENTIAL_AUTH_FOUND = "Y" then 1 If POTENTIAL_AUTH_FOUND = "N" then 0 Otherwise NULL

    Count

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    1
    Delete value
    0

    _CreationInstant

    : date/time

    Properties

    Data type
    date/time
    SQL Server data type
    datetime
    Allows null
    Yes

    _LastUpdatedInstant

    : date/time

    Properties

    Data type
    date/time
    SQL Server data type
    datetime
    Allows null
    Yes

    _IsInferred

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
    Default value
    0

    _IsDeleted

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    Yes
    Default value
    0

    _PrimaryPackageToImpactRecord

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    empty string

    _MostRecentPackageToImpactRecord

    : string

    Properties

    Data type
    string
    SQL Server data type
    nvarchar(50)
    Allows null
    No
    Default value
    *Unknown
    Delete value
    empty string

    _NumberOfSources

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    smallint
    Allows null
    No
    Default value
    0

    _HasSourceClarity

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0

    _DeletedFromSourceClarity

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0

    _HasSourceCmsAco

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0

    _DeletedFromSourceCmsAco

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0

    _HasSourceCmsCjr

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0

    _DeletedFromSourceCmsCjr

    : integer

    Properties

    Data type
    integer
    SQL Server data type
    tinyint
    Allows null
    No
    Default value
    0